{"id":13708,"date":"2023-06-05T18:49:33","date_gmt":"2023-06-05T18:49:33","guid":{"rendered":"https:\/\/healthyaging.net\/magazine\/?p=13708"},"modified":"2023-06-07T12:19:54","modified_gmt":"2023-06-07T12:19:54","slug":"lighting-the-way-to-prevent-falls","status":"publish","type":"post","link":"https:\/\/healthyaging.net\/magazine\/spring-summer-2023\/lighting-the-way-to-prevent-falls\/","title":{"rendered":"Lighting the Way to Prevent Falls"},"content":{"rendered":"

By David Pedler<\/p><\/p>\n

T<\/span>he risks and high cost of medical treatment for falls among older adults in the US are all too familiar. Over 2.8 million of us fall per year, 37,000 succumb to their injuries, and the annual cost of treating the 1.8 million older adults visiting hospitals for falls treatment stands at about $50 billion.<\/p>\n

Prevention strategies range from patient assessment, physical conditioning, and education to the modification of living spaces and care protocols.<\/p>\n

Yet for whatever reasons, carefully crafted lighting interventions rarely, if ever, seem to be a high priority on fall prevention checklists.<\/p>\n

When lighting is mentioned, it typically involves broad directives to \u201cimprove\u201d seniors\u2019 lighted environment with \u201cgood,\u201d \u201cproper,\u201d or \u201cadequate\u201d lights. Installing conventional night lights is often mentioned, and it is sometimes (if rarely) recommended that \u201clighted pathways\u201d be established to bathrooms or other frequent nighttime indoor destinations.<\/p>\n

But how can these lighted pathways be established?<\/p>\n

\"\"<\/a><\/p>\n

To answer this question, it is important to first establish why such pathways are important. Balance and postural stability, which are essential elements for avoiding falls, rely on a complex interplay between various body systems (e.g., sensory, musculoskeletal, neuromuscular, vestibular, and cognitive) that deteriorate as we age.<\/p>\n

Age-related changes to the eyes that reduce the quality of our nighttime vision, for example, can conceal obstacles and disturb our awareness of our body and surroundings.<\/p>\n

Cognitive decline, even when relatively mild, can affect our sense of planning and awareness of our destination while also affecting our ability to hold attention and respond to risks, obstacles, and our surroundings.<\/p>\n

As a result, we tend move more slowly and tentatively, taking shorter steps and maybe even avoiding movement whenever possible. Combined, each of these problems can compound the others and further increase our risk for falls.<\/p>\n

Visual cues such as those provided by carefully crafted nighttime lighting, on the other hand, can assist the eyes and promote balance, reinforce our sense of direction, and increase confidence in our gait without prompting wakefulness and making sleep difficult after returning to bed.<\/p>\n

Novel LED lighting systems delivering low-intensity, horizontal and vertical lights that outline bedroom and bathroom doorframes have recently been developed. These new systems are based on research by scientists at the Light and Health Research Center<\/a> (LHRC) at Mount Sinai, who found that providing horizontal and vertical visual cues for better balance and postural stability at night can reduce the risk for falls.<\/p>\n

A recent study employing the system in five assisted living facilities, unfortunately cut short due to the outbreak of the COVID-19 pandemic, showed a promising 33% reduction in falls, but further research is needed.<\/p>\n

New and improved prototypes of the device are now being tested in a metropolitan hospital ward and in a year-long trial at an assisted living facility to assess their effectiveness for avoiding falls compared to conventional lighting conditions.<\/p>\n

\u201cLighting can not only evoke visual sensations, like bright versus dim or warm versus cool. It can also give us accurate perceptual information about the world around us,\u201d says LHRC Director and Icahn School of Medicine<\/a> at Mount Sinai Professor Mariana G. Figuiero.<\/p>\n

\u201cThese \u2018stabilizing night lights\u2019 provide horizontal and vertical reference points to help people reckon their position in otherwise darkened spaces. They show tremendous promise in reducing the risk for falls among vulnerable populations like people living with dementia.\u201d<\/p>\n

\"\"<\/a>This innovative lighting system can be installed in new buildings or retrofitted into existing facilities and even homes. And because the system is fully automated, it requires no further attention after installation.<\/p>\n

At the very least, LHRC researchers expect that this lighting system holds great promise as a new standard in dementia care and falls reduction. Given its ease of use and advantages even among older adults without dementia, there is every reason to believe that such lighting could be as common as other ADA-compliant fixtures, like grab bars.<\/p>\n

Does this sound too good to be true?<\/p>\n

It is by and large, at least for the moment, as these systems have not yet made their way into the retail consumer market and only a single manufacturer (Axis Lighting<\/a>) is producing LED doorframe trim lighting for hardwired architectural applications. Fortunately, lighting systems for both market sectors are in development and should be appearing soon. But there are steps we can take in the meantime.<\/p>\n

For now, it is advisable that older adults \u2014 or even people of all ages and health conditions \u2014follow the helpful guidelines for avoiding falls established by the National Institute on Aging<\/a>.<\/p>\n