Lighting Effects on Older Adults’ Visual and Nonvisual Performance: A Systematic Review

Abstract

Lighting plays an important role in daily life: It helps people perform daily activities independently and safely, and also benefits their health. This study assesses the research evidence of lighting’s impacts on older adults in four domains: (a) performance of activities of daily living and instrumental activities of daily living; (b) circadian rhythm; (c) fall prevention and postural stability; and (d) sleep quality. A comprehensive review of lighting studies on older adults’ visual and nonvisual performance was conducted using a modified PRISMA systematic review process. For the first domain, some older adults had difficulty in using the toilet, preparing meals, and doing laundry under lower illuminance. For the second domain, brighter and bluish lighting improved older adults’ circadian rhythm. For the third domain, low-intensity LED lighting affixed on door frames can help older adults maintain postural stability and prevent falling during nighttime movement. Finally, some studies concluded that receiving outdoor daylight during exercise was beneficial to older adults’ sleep quality. This study provides several methodological, theoretical, and collaborative suggestions for developing a more conclusive evidence base for lighting standards and strategies for older adults.

Keywords:

• Visual and nonvisual task
• circadian rhythm
• falls
• sleep

Notes

1 The lighting standard for seniors is titled “Lighting and the Visual Environment for Seniors and the Low Vision Population.” It includes quality and quantity of lighting for vision, design guide, light source, daylight, light for seniors’ health, and lighting controls.

2 In Shikder and colleagues’ review, the psychophysiological performance included depression, circadian sleep–wake cycle disorder, and restless behavior among patients with dementia. Since this review mainly focuses on generally healthy older adults, no restless behavior is examined. For consistency throughout the review, Shikder’s review aspects are referred as visual and nonvisual performance.

3 It happened that all search results were published after 1990.

4 Since very few systematic studies on illuminance effects on older adults’ falls have been conducted in residential settings, two laboratory-based studies on this topic were included.

5 This study is performed under lab-controlled environment. The reason to include this particular lab study is that a subsequent study by Figueiro et al. (2008a) is built upon this research.

6 In the studies of Obayashi and colleagues (2012, 2014a, 2014b), the night light is measured by portable lighting meters placed 60 cm above the floor, near the bed, facing the ceiling.