Alzheimers and Light Therapy - Learning Objectives
Long Term Care Facility Lighting and Patients with Alzheimer Disease
Lighting in long-term care facilities is usually not bright enough during the day and perhaps too bright during the evening. Typical indoor lighting provides less than 100 lux at the eye, whereas being outside on a sunny day will provide anywhere from 1,000 to more than 10,000 lux at the eye. Older adults in long-term care facilities often spend their days and nights in dimly-lit rooms with minimal time spent outdoors, and thus, are not experiencing the robust daily patterns of light and dark that synchronize the body’s circadian clock to local sunrise and sunset. 
Effects of a Tailored Lighting Intervention on Sleep Quality, Rest–Activity, Mood, and Behavior in Older Adults With Alzheimer Disease and Related Dementias: A Randomized Clinical Trial
The active intervention significantly improved Pittsburgh Sleep Quality Index scores compared to the active baseline and control intervention (mean ± SEM: 6.67 ± 0.48 after active intervention, 10.30 ± 0.40 at active baseline, 8.41 ± 0.47 after control intervention). The active intervention also resulted in significantly greater active versus control differences in intradaily variability. As for secondary outcomes, the active intervention resulted in significant improvements in Cornell Scale for Depression in Dementia scores (mean ± SEM: 10.30 ± 1.02 at baseline, 7.05 ± 0.67 after active intervention) and significantly greater active versus control differences in Cohen-Mansfield Agitation Inventory scores (mean ± SEM: −5.51 ± 1.03 for the active intervention, −1.50 ± 1.24 for the control intervention).
A lighting intervention tailored to maximally entrain the circadian system can improve sleep, mood, and behavior in patients with dementia living in controlled environments.
Melatonin for sleep
Light Treatment for SAD
"Treatment for seasonal affective disorder may include light therapy, medications and psychotherapy. If you have bipolar disorder, tell your doctor — this is critical to know when prescribing light therapy or an antidepressant. Both treatments can potentially trigger a manic episode.
In light therapy, also called phototherapy, you sit a few feet from a special light therapy box so that you're exposed to bright light. Light therapy mimics natural outdoor light and appears to cause a change in brain chemicals linked to mood.
Light therapy is one of the first line treatments for fall-onset SAD. It generally starts working in a few days to two weeks and causes few side effects. Research on light therapy is limited, but it appears to be effective for most people in relieving SAD symptoms.
Before you purchase a light therapy box, talk with your doctor about the best one for you, and familiarize yourself with the variety of features and options so that you buy a high-quality product that's safe and effective.' 
Hazards of Light Boxes & Light Therapy
Light is powerful and can harm as well as help. Do no harm, and use caution, when using light therapy. Some light boxes, especially fluorescent, may increase the risk of Macular Degeneration and cataracts  from overexposure to UV light. Purchase and use Light Boxes with low UV - ultraviolet radiation below 400 nm.
"It is also essential to remove very short violet-blue visible light (400 to 440nm) from all therapeutic slight sources, as these wavelengths of light present a risk of retinal damage to patients above 50 years old.
There is even greater hazard if light therapy is given in conjunction with a phototoxic prescription  or herbal (including St. John's Wort) antidepressant medication, as this can lead to transient or permanent blindness." 
White Light–Emitting Diodes (LEDs) at Domestic Lighting Levels and Retinal Injury in a Rat Model
Background: Light-emitting diodes (LEDs) deliver higher levels of blue light to the retina than do conventional domestic light sources. Chronic exposure to high-intensity light (2,000–10,000 lux) has previously been found to result in light-induced retinal injury, but chronic exposure to relatively low-intensity (750 lux) light has not been previously assessed with LEDs in a rodent model. 
10 Tips to Get the Most Out of Light Therapy
This well written article explains some of the techniques and tips for using Light Therapy, written by: Marlynn Wei, MD, JD Harvard-trained Psychiatrist, Certified Yoga Teacher, Author of The Harvard Medical School Guide to Yoga
Go for an early morning walk.
According to Dak Kopec, BAC Director of Design for Human Health, Boston Architectural College, “Take a walk at 7:00 am, there is the least air pollution at that time.” When I asked him why, he said, “Particulates are trapped by moisture in the air and fall to the ground.”
Ahh, no wonder my car gets filthy overnight parked on the streets of LA.
7:00 AM is the best time to walk.
US Department of Energy