The Effect of Ultraviolet B Irradiation Compared with Oral Vitamin D Supplementation on the Well-being of Nursing Home Residents with Dementia: A Randomized Controlled Trial.

Bistra I Veleva,Monique A A Caljouw,Bart J A Mertens,Victor G M Chel,Mattijs E Numans,Jenny T Van Der Steen

doi:10.3390/ijerph17051684

Bistra I Veleva, Monique A A Caljouw + Show 4 more

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https://doi.org/10.3390/ijerph17051684

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Abstract

There are indications that ultraviolet B (UVB) exposure has beneficial effects on well-being through mechanisms other than vitamin D synthesis alone. We conducted a randomized controlled multicenter trial to compare the effects of UVB light and vitamin D supplementation (VD) in terms of the well-being of nursing home residents with dementia. Participants were randomly assigned to the intervention group (UVB group, n = 41; half-body UVB irradiation, twice weekly over 6 months, with 1 standard erythema dose (SED)) or to the control group (VD group, n = 37; 5600 International units (IU) cholecalciferol supplementation once a week). The main outcome was well-being, measured by the Cohen-Mansfield Agitation Inventory (CMAI) and the Cornell scale for depression in dementia at 0, 3, and 6 months. Secondary outcomes were QUALIDEM quality of life domains and biochemical parameters of bone homeostasis. Intention-to-treat analysis with linear mixed modeling showed no significant between-group differences on agitation (p = 0.431) or depressive symptoms (p = 0.982). At six months, the UVB group showed less restless/tense behavior compared to the VD group (mean difference of the mean change scores 2.2, 95% CI 0.8 to 3.6; p = 0.003 for group x time interaction) and lower serum 25(OH)D3 concentration (estimated mean difference - 21.9, 95% CI −32.6 to −11.2; p = 0.003 for group difference). The exposure of nursing home residents with dementia to UVB light showed no positive benefits in terms of wellbeing. UVB treatment may have a positive effect on the restless/tense behavior characteristic of advanced dementia but more research is needed to confirm this finding.

Highlights

Observational studies indicate that low sun exposure increases the risk of cardiovascular disease [1,2]and that there is a strong inverse relationship between all-cause mortality and sun exposure [1].Therapy using ultraviolet (UV) light is an important treatment option for several skin diseases [3].A mood-enhancing effect of UV light has been reported [4,5,6,7,8,9]
The legal representatives of seventy-nine nursing home residents gave informed consent to participate in the study (Figure 1)
The first randomized control trial to assess the effect of ultraviolet B (UVB) on agitation and depression in people with dementia, we found no significant effect of UVB light on the well-being of nursing home residents

Summary

Introduction

Observational studies indicate that low sun exposure increases the risk of cardiovascular disease [1,2]and that there is a strong inverse relationship between all-cause mortality and sun exposure [1].Therapy using ultraviolet (UV) light is an important treatment option for several skin diseases [3].A mood-enhancing effect of UV light has been reported [4,5,6,7,8,9]. Observational studies indicate that low sun exposure increases the risk of cardiovascular disease [1,2]. That there is a strong inverse relationship between all-cause mortality and sun exposure [1]. Therapy using ultraviolet (UV) light is an important treatment option for several skin diseases [3]. A mood-enhancing effect of UV light has been reported [4,5,6,7,8,9]. UV light acting on the skin is absorbed by 7-dehydrocholesterol in the plasma membrane of epidermal cells, resulting in production. Res. Public Health 2020, 17, 1684; doi:10.3390/ijerph17051684 www.mdpi.com/journal/ijerph

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