TY - JOUR

T1 - An exploratory investigation of the effect of naturalistic light on depression, anxiety, and cognitive outcomes in stroke patients during admission for rehabilitation

T2 - A randomized controlled trial

AU - West, Anders

AU - Simonsen, Sofie Amalie

AU - Zielinski, Alexander

AU - Cyril, Niklas

AU - Schønsted, Marie

AU - Jennum, Poul

AU - Sander, Birgit

AU - Iversen, Helle K

PY - 2019

Y1 - 2019

N2 - BACKGROUND: Patients admitted for rehabilitation often lack sufficient natural light to entrain their circadian rhythm.OBJECTIVE: Installed diurnal naturalistic light may positively influence the outcome of depressive mood, anxiety, and cognition in such patients.METHODS: A quasi-randomized controlled trial. Ninety stroke patients in need of rehabilitation were randomized between May 1, 2014, and June 1, 2015 to either a rehabilitation unit equipped entirely with always on naturalistic lighting (IU), or to a rehabilitation unit with standard indoor lighting (CU).Examinations were performed at inclusion and discharge. The following changes were investigated: depressive mood based on the Hamilton Depression scale (HAM-D6) and Major Depression Inventory scale (MDI), anxiety based on the Hospital Anxiety and Depression Scale (HADS), cognition based on the Montreal Cognitive Assessment (MoCA) and well-being based on the Well-being Index (WHO-5).RESULTS: Depressive mood (MDI p = 0.0005, HAM-D6 p = 0.011) and anxiety (HADS anxiety p = 0.045) was reduced, and well-being (WHO-5 p = 0.046) was increased, in the IU at discharge compared to the CU. No difference was found in cognition (MoCA p = 0.969).CONCLUSIONS: This study is the first to demonstrate that exposure to naturalistic light during admission may significantly improve mental health in rehabilitation patients. Further studies are needed to confirm these findings.

AB - BACKGROUND: Patients admitted for rehabilitation often lack sufficient natural light to entrain their circadian rhythm.OBJECTIVE: Installed diurnal naturalistic light may positively influence the outcome of depressive mood, anxiety, and cognition in such patients.METHODS: A quasi-randomized controlled trial. Ninety stroke patients in need of rehabilitation were randomized between May 1, 2014, and June 1, 2015 to either a rehabilitation unit equipped entirely with always on naturalistic lighting (IU), or to a rehabilitation unit with standard indoor lighting (CU).Examinations were performed at inclusion and discharge. The following changes were investigated: depressive mood based on the Hamilton Depression scale (HAM-D6) and Major Depression Inventory scale (MDI), anxiety based on the Hospital Anxiety and Depression Scale (HADS), cognition based on the Montreal Cognitive Assessment (MoCA) and well-being based on the Well-being Index (WHO-5).RESULTS: Depressive mood (MDI p = 0.0005, HAM-D6 p = 0.011) and anxiety (HADS anxiety p = 0.045) was reduced, and well-being (WHO-5 p = 0.046) was increased, in the IU at discharge compared to the CU. No difference was found in cognition (MoCA p = 0.969).CONCLUSIONS: This study is the first to demonstrate that exposure to naturalistic light during admission may significantly improve mental health in rehabilitation patients. Further studies are needed to confirm these findings.

KW - Aged

KW - Aged, 80 and over

KW - Anxiety/epidemiology

KW - Cognition/physiology

KW - Depression/epidemiology

KW - Female

KW - Humans

KW - Male

KW - Middle Aged

KW - Patient Admission/trends

KW - Phototherapy/methods

KW - Psychiatric Status Rating Scales

KW - Stroke/epidemiology

KW - Stroke Rehabilitation/methods

KW - Treatment Outcome

U2 - 10.3233/NRE-182565

DO - 10.3233/NRE-182565

M3 - Journal article

C2 - 31177236

VL - 44

SP - 341

EP - 351

JO - NeuroRehabilitation

JF - NeuroRehabilitation

SN - 1053-8135

IS - 3

ER -