FPIN's Clinical Inquiries
Does Light Therapy Decrease Depression in Older Adults?
Am Fam Physician. 2021 Oct ;104(4):417-418.
Does light therapy decrease depression in older adults without seasonal depression?
Light therapy appears to be mildly effective in treating depression in older adults, but ideal wavelength, intensity, and length of treatment are unknown. (Strength of Recommendation [SOR]: B, based on a systematic review of randomized controlled trials [RCTs] with heterogeneity and extrapolated from systematic reviews of RCTs of adults of all ages.) In adults, bright white light exposure in the mornings for less than 60 minutes may be most effective. (SOR: B, based on a systematic review of RCTs.)
A 2018 systematic review and meta-analysis of six RCTs (N = 359) examined the effectiveness of light therapy among patients older than 60 years with nonseasonal depression.1 The trials compared light therapy (of varying wavelength, intensity, and duration) to either dim red or white light, nothing, or usual therapy. Trials were conducted for four weeks (three trials), three weeks (one trial), or no more than two weeks (two trials). The pooled results of all trials found that geriatric depression symptoms improved more with a small to moderate effect in the light therapy groups compared with the control groups (standardized mean difference [SMD] = 0.45; 95% CI, 0.14 to 0.75). Subgroup analysis by length of intervention revealed no statistically significant differences between treatment and control groups at two weeks (two trials; n = 117; SMD = −0.18; 95% CI, −0.54 to 0.18; I2 = 0%), three weeks (two trials; n = 165; SMD = 0.38; 95% CI, −0.36 to 1.13; I2 = 83%), or four weeks (three trials; n = 179; SMD = 0.25; 95% CI, −0.05 to 0.54; I2 = 0%). In all six trials, there were no significant adverse reactions in the treatment group. The treatment and control groups did not differ in the rates of adverse reactions reported. Because of limited available evidence, the authors were not able to make conclusions regarding the ideal wavelength, intensity, or duration
Referencesshow all references
1. Zhao X, Ma J, Wu S, et al. Light therapy for older patients with non-seasonal depression: a systematic review and meta-analysis. J Affect Disord. 2018;232:291–299....
2. Tao L, Jiang R, Zhang K, et al. Light therapy in non-seasonal depression: an update meta-analysis. Psychiatry Res. 2020;291:113247.
3. Gelenberg AJ, Freeman MP, Markowitz JC, et al.; Work Group on Major Depressive Disorder; American Psychiatric Association. Practice guideline for the treatment of patients with major depressive disorder. 3rd ed. 2010. Accessed July 30, 2020. https://psychiatryonline.org/pb/assets/raw/sitewide/practice_guidelines/guidelines/mdd.pdf
4. American Geriatrics Society 2015 Beers Criteria Update Expert Panel. American Geriatrics Society 2015 updated Beers Criteria for potentially inappropriate medication use in older adults. J Am Geriatr Soc. 2015;63(11):2227–2246.
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