Improved spontaneous outings of elderly residents during seasonal light-emitting diode pixel mapping entertainment in a nursing home courtyard

Abstract

As we age, the various biological mechanisms that govern our physical and mental functions decline, leading to the deterioration in our sensory, motor, cognitive, and other functions. Before we realize it, the combined effects of these changes may diminish our motivation to live well. In today’s increasingly diverse and complex society, it is important to support senior citizens in maintaining their prosocial motivation and to help them sustain this throughout their lives. To address this, the present study explored the effectiveness of light-emitting diode (LED) entertainment as a tool to promote physical activity and mental well-being among nursing home residents. In December 2023, LED pixel mapping entertainment using digitally controlled illumination was held in the courtyard of a Japanese nursing home for elderly residents. The results showed that approximately 97% of the facility’s residents reported improvement in mood as a result of the show. In addition, most residents typically spent most of their time in their rooms, except when gathering in the dining room for meals or in-house events. However, during the light show, many residents were observed visiting the location where the illuminations were set up or moving to the windows to watch the show, with other spontaneous outings also occurring.

Keywords

Geriatric psychology / Illumination therapy / Outdoor nature / Mental health / Stress / Dementia / Withdrawal / Depression

Acknowledgments

We would like to express our sincere gratitude to the staff of the Izumi Welfare Association, including Executive Director Ito, for sponsoring and assisting in the organization of the illumination event.

Funding

This study was supported by Yamaguchi University, Tohoku University, and Saitama Medical.

Conflict of interest

The first author is a professional engineer in the study’s technology, which is relevant to the topic of this article. This has not influenced the content of the manuscript. Separately, the other authors declare no known competing financial interests or personal relationships that could have influenced the work reported in this paper.

Author contributions

Conceptualization: Shinichi Sakamoto, Mamiko Koshiba

Formal analysis: Shinichi Sakamoto, Mamiko Koshiba

Investigation: All authors

Methodology: Shinichi Sakamoto, Mamiko Koshiba

Writing - original draft: Shinichi Sakamoto, Mamiko Koshiba

Writing - review & editing: All authors

Ethics approval and consent to participate

The study protocol was approved by the Yamaguchi University Review Committee for Non-Medical Research Involving Human Participants (2023-064). Participants in the research have obtained consent from the facility manager and have given their consent based on their own free will.

Consent for publication

Informed consent for publication was obtained from the relevant participants.

Availability of data

The datasets for this study are available in the text. Due to regulations at the nursing care facility, only a video can be shown at the following URL: https://www.youtube.com/shorts/wGpxcTKTIUE. For additional reference data, readers can refer to the following URL, which shows another event video of our digital control LED pixel mapping entertainment illumination: https://www.youtube.com/watch?v=Omp0bibI9wc.

References

[1] Yamada M, Arai H. Long-term care system in Japan. Ann Geriatr Med Res. 2020; 24:174-180. doi: 10.4235/agmr.20.0037

[2] Kitamura A, Seino S, Abe T, et al. Sarcopenia: Prevalence, associated factors, and the risk of mortality and disability in Japanese older adults. J Cachexia Sarcopenia Muscle. 2021; 12:30-38. doi: 10.1002/jcsm.12651

[3] Kato TA, Tateno M, Shinfuku N, et al. Does the ‘hikikomori’ syndrome of social withdrawal exist outside Japan? A preliminary international investigation. Soc Psychiatry Psychiatr Epidemiol. 2012;47:1061-1075. doi: 10.1007/s00127-011-0411-7

[4] Hasegawa Y, Sakuramoto-Sadakane A, Nagai K, et al. Does oral hypofunction promote social withdrawal in the older adults? A longitudinal survey of elderly subjects in rural Japan. Int J Environ Res Public Health. 2020;17:8904. doi: 10.3390/ijerph17238904

[5] Iijima K, Arai H, Akishita M, et al. Toward the development of a vibrant, super-aged society: The future of medicine and society in Japan. Geriatr Gerontol Int. 2021; 21:601-613. doi: 10.1111/ggi.14201

[6] Kino S, Stickley A, Nishioka D, et al. Suicidal ideation and suicide attempts among older recipients of public welfare assistance in Japan. J Epidemiol Community Health. 2022;76:873-879 doi: 10.1136/jech-2022-218893

[7] Kawachi I, Aida J, Hikichi H, Kondo K. Disaster resilience in aging populations: Lessons from the 2011 great east Japan earthquake and tsunami. J R Soc N Z. 2020;50:263-278. doi: 10.1080/03036758.2020

[8] Chen Y, Hou L, Li Y, et al. Barriers and motivators to promotion of physical activity participation for older adults with mild cognitive impairment or dementia: An umbrella review. Int J Nurs Stud. 2023;143:104493. doi: 10.1016/j.ijnurstu.2023.104493

[9] Tao T, Sato R, Matsuda Y, et al. Elderly body movement alteration at 2^ndexperience of digital art installation with cognitive and motivation scores. J Multidiscip Sci J. 2020;3:138-150. doi: 10.3390/j3020012

[10] Hertzog C, Kramer AF, Wilson RS, Lindenberger U. Enrichment effects on adult cognitive development: Can the functional capacity of older adults be preserved and enhanced? Psychol Sci Public Interest. 2008; 9:1-65. doi: 10.1111/j.1539-6053.2009.01034.x

[11] O’Neill M, Ryan A, Tracey A, Laird L. ‘Waiting and wanting’: Older peoples’ initial experiences of adapting to life in a care home: A grounded theory study. Ageing Soc. 2022;42: 351-375. doi: 10.1017/S0144686X20000872

[12] Shinichi Sakamoto MK. An approach to the alleviation of psychological stress in nursing home residents using LED illumination. Int Neurosci Biol Psychiatry Reg Conf Asia. 2024;17:1-4.

[13] Shinichi Sakamoto MK. The three-year effect of the large-scale winter LED illumination event at a local amusement park on increasing the number of visitors. Stress Brain Behav. 2024;3:1-19.

[14] Fadzil II, Ghazali AS, Jasni F, Hafizalshah MH. Enhancing mental health through ambient lighting. Int Hum Eng Symp. 2024;2023:19-31.

[15] Olson R. The stretch of holiday decorations. Grassroots Writ Res J. 2018;10.1:19-29.

[16] Maalouly E, Hirano T, Yamazaki R, Nishio S, Ishiguro H. Encouraging prosocial behavior from older adults through robot teleoperation: A feasibility study. Front Comput Sci. 2023;5:1157925. doi: 10.3389/fcomp.2023.1157925

[17] Liu J, Sun X, Chen H, Yang Z. Passive nature exposure positively predicts prosocial behavior by alleviating perceived crowdedness. J Environ Psychol. 2023;91:102146. doi: 10.1016/j.jenvp.2023.102146

[18] Kawamura S, Tachibanaki S. Molecular bases of rod and cone differences. Prog Retin Eye Res. 2022;90:101040. doi: 10.1016/j.preteyeres.2021

[19] Athanasiou D, Aguila M, Bellingham J, et al. The molecular and cellular basis of rhodopsin retinitis pigmentosa reveals potential strategies for therapy. Prog Retin Eye Res. 2018; 62:1-23. doi: 10.1016/j.preteyeres.2017.10.002

[20] De Silva SR, Arno G, Robson AG, et al. The X-linked retinopathies: Physiological insights, pathogenic mechanisms, phenotypic features and novel therapies. Prog Retin Eye Res. 2021;82:100898. doi: 10.1016/j.preteyeres.2020.100898

[21] Kleinlogel S, Vogl C, Jeschke M, Neef J, Moser T. Emerging approaches for restoration of hearing and vision. Physiol Rev. 2020; 100:1467-1525. doi: 10.1152/physrev.00035.2019

[22] Ishihara K, Ishihara S, Nagamachi M, Hiramatsu S, Osaki H. Age-related decline in color perception and difficulties with daily activities-measurement, questionnaire, optical and computer-graphics simulation studies. Int J Ind Ergon. 2001;28:153-163. doi: 10.1016/S0169-8141(01)00028-2

[23] Trukša R, Fomins S, Jansone-Langina Z, Tenisa L. Colour vision changes across lifespan: Insights from FM100 and CAD tests. Vision. 2024;8:53. doi: 10.3390/vision8030053

[24] Karino G, Senoo A, Kunikata T, et al. Inexpensive home infrared living/environment sensor with regional thermal information for infant physical and psychological development. Int J Environ Res Public Health. 2020;17:6844. doi: 10.3390/ijerph17186844

[25] Koshiba M, Watarai-Senoo A, Karino G, et al. A susceptible period of photic day-night rhythm loss in common marmoset social behavior development. Front Behav Neursci. 2021;14:539411. doi: 10.3389/fnbeh.2020.539411

[26] Shikder S, Mourshed M, Price A. Therapeutic lighting design for the elderly: A review. Perspect Public Health. 2012;132:282-291. doi: 10.1177/1757913911422288

[27] Terman M, Terman JS. Light therapy for seasonal and nonseasonal depression: Efficacy, protocol, safety, and side effects. CNS Spectr. 2005;10:647-663; quiz 672. doi: 10.1017/s1092852900019611

[28] Mylona I, Floros GD. Blue light blocking treatment for the treatment of bipolar disorder: Directions for research and practice. J Clin Med. 2022;11:1380. doi: 10.3390/jcm11051380

[29] Do A, Li VW, Huang S, et al. Blue-light therapy for seasonal and non-seasonal depression: A systematic review and meta-analysis of randomized controlled trials. Can J Psychiatry. 2022;67:745-754. doi: 10.1177/07067437221097903

[30] Ota M, Hariyama M, Colman R, Koshiba M. The effects of ubiquinol intake and sociophysical training on the activation of psychological and infrared camera-measured body temperature physiology and blood molecular markers: A pilot study among healthy female older adults. Appl Sci. 2024;14:2366. doi: 10.3390/app14062366

[31] Sari NPWP, Manungkalit M. The best predictor of anxiety, stress, and depression among institutionalized elderly. Int J Publ Health Sci. 2019; 8:419-426. doi: 10.11591/ijphs.v8i4.20359

[32] Kubo H, Urata H, Sakai M, et al. Development of 5-day hikikomori intervention program for family members: A single-arm pilot trial. Heliyon. 2020;6:e03011. doi: 10.1016/j.heliyon.2019.e03011

[33] Luppa M, Pabst A, Löbner M, et al. Age-specific risk factors of depression among the oldest-old - evidence from the multicenter agecode-agequalide study. Front Psychiatry. 2024;15:1367225. doi: 10.3389/fpsyt.2024.1367225

[34] Tucker-Drob EM, De La Fuente J, Köhncke Y, Brandmaier AM, Nyberg L, Lindenberger U. A strong dependency between changes in fluid and crystallized abilities in human cognitive aging. Sci Adv. 2022;8:eabj2422. doi: 10.1126/sciadv.abj2422

[35] Zeilig H. Dementia as a cultural metaphor. Gerontologist. 2014;54:258-267. doi: 10.1093/geront/gns203

[36] Hoffman P, Loginova E, Russell A. Poor coherence in older people’s speech is explained by impaired semantic and executive processes. Elife. 2018;7:e8907. doi: 10.7554/eLife.38907

[37] Birrer RB, Vemuri SP. Depression in later life: A diagnostic and therapeutic challenge. Am Fam Physician. 2004;69: 2375-2382.

[38] Devita M, De Salvo R, Ravelli A, et al. Recognizing depression in the elderly: Practical guidance and challenges for clinical management. Neuropsychiatr Dis Treat. 2022; 18:2867-2880. doi: 10.2147/NDT.S347356

[39] Mukku SSR, Dahale AB, Muniswamy NR, Muliyala KP, Sivakumar PT, Varghese M. Geriatric depression and cognitive impairment-an update. Indian J Psychol Med. 2021;43:286-293. doi: 10.1177/0253717620981556

[40] Jellinger KA. Pathomechanisms of vascular depression in older adults. Int J Mol Sci. 2022;23:308. doi: 10.3390/ijms23010308

[41] Wu Y, Mai N, Weng X, Liang J, Ning Y. Changes of altruistic behavior and kynurenine pathway in late-life depression. Front Psychiatry. 2020;11:338. doi: 10.3389/fpsyt.2020.00338

[42] Zou H, Zhou H, Yan R, Yao Z, Lu Q. Chronotype, circadian rhythm, and psychiatric disorders: Recent evidence and potential mechanisms. Front Neurosci. 2022;16:811771. doi: 10.3389/fnins.2022.811771

[43] Alexopoulos GS. Depression in the elderly. Lancet. 2005;365:1961-1970. doi: 10.1016/S0140-6736(05)66665-2

[44] Zhai K, Dilawar A, Yousef MS, Holroyd S, El-Hammali H, Abdelmonem M. Virtual reality therapy for depression and mood in long-term care facilities. Geriatrics (Basel). 2021;6:58. doi: 10.3390/geriatrics6020058