JMIR Publications

ABSTRACT

Background:

One of the common challenges for individuals caring for people with Alzheimer’s disease or related dementias is the behavioral and psychological symptoms. Managing their behavioral and psychological symptoms effectively will increase their quality of life, lessen caregivers’ burden, and lower healthcare cost.

Objective:

In this review, we seek to identify the following: 1. How indoor environmental quality parameters pertaining to light level, noise level, temperature, and humidity are associated with behavioral and psychological symptoms of dementia and how controlling these parameters can help manage these symptoms. 2. The current state of research in this area, current gaps in the research, and potential future directions.

Methods:

Searches were conducted in CINAHL, EMBASE, Medline, and PsycInfo databases for papers published from 2007 to April 2022. We searched for studies examining the relationship between indoor environmental quality parameters pertaining to light, noise, temperature, and/or humidity, and the behavioral and psychological symptoms of dementia.

Results:

A total of 3,123 papers were identified in the original search in October 2020. After screening, a total of 29 papers were included. Another search was conducted in April 2022 which identified 9 additional papers. Among included papers, light was the most studied environmental factor while there were relatively few studies on the relationships between other environmental factors and behavioral and psychological symptoms of dementia. Several studies examined multiple environmental factors simultaneously. Subjective data were used in most studies in assessing the environment. There appears to be an association between environmental factors and behavioral and psychological symptoms of dementia. Across all environmental factors, results suggest that when the environment was potentially uncomfortable, such as being over-stimulating or under-stimulating, behavioral symptoms of people living with dementia will be exacerbated.

Conclusions:

There appears to be an association between environmental factors and behavioral and psychological symptoms of dementia. However, light was the most examined factor while other indoor environmental quality parameters such as noise, temperature and humidity were under-examined. There is a need for more objective measurements of both the indoor environmental quality parameters and behavioral symptoms. One future direction is to incorporate objective sensing and advanced computational methods in real-time assessments and initiate just-in-time environmental interventions.