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Stroke prevention and recovery – lighting can help
Stroke is the second-largest cause of death worldwide, and fourth in the UK. It is the leading neurological disease in terms of Disability-Adjusted Years in Europe and the US, with an average cost per stroke patient per year in the USA at an estimated $59,900 – The economic burden of stroke: a systematic review of cost of illness studies.
You might think stroke’s just a problem for older people (we’ll think about it tomorrow).
But around one in four strokes happen among working-age people – Current, future and avoidable costs of stroke in the UK, set to rise at an estimated 1% per year with a 58% rise in hospital admissions for 50-59 year olds in the UK in last 20 years – Hospital admissions for strokes rise by 28% since 2004 – as NHS urges the public to ‘Act FAST’.
That’s suddenly a lot closer to home!
So what can you do?
There’s a strong link between a healthy body clock and your risk of having a stroke, the extent of the injury if you have one – and how well you recover.. – Circadian Biology and Stroke.
Here’s where lighting can help.
For prevention – Biobank analysis of over 85,000 records suggest that people with the highest levels of daytime light exposure are at lowest risk of cardiovascular disease, a predictor of stroke – Brighter nights and darker days predict higher mortality risk: A prospective analysis of personal light exposure in >88,000 individuals. People exposed to artificial light at night are at far greater risk, with one study identifying a 43% increased risk of stroke for those with the highest compared to the lowest exposure – Outdoor Light at Night, Air Pollution, and Risk of Cerebrovascular Disease: A Cohort Study in China.
When it comes to recovery, lighting that actively supports the sleep-wake cycle makes a big difference too. Simply boosting light levels in the morning can improve sleep at night – 1134 Light Exposure At Daytime On Sleep Quality In Stroke Patient During Rehabilitation, while exposure to a full ‘naturalistic’ circadian cycle of blue-enhanced bright days and dark nights improved melatonin and cortisol regulation compared to ‘standard’ hospital lighting – The Effects of Naturalistic Light on Diurnal Plasma Melatonin and Serum Cortisol Levels in Stroke Patients during Admission for Rehabilitation: A Randomized Controlled Trial.
Dr Anders West will share this and other fascinating research next Thursday 17th of April at 2pm as part of our Innovators in Healthcare event.
Please register for this free online event here.
With thanks to our sponsors Circadacare, Chromaviso, Commercial Lighting Systems Ltd and Nobi Smart Lights and to our media partners darc media, designing lighting, Lighting Industry Association (The LIA), The Light Review and the SLL – Society of Light and Lighting.
Get lost – and found
On my way to Euroluce. I’m fully expecting to get hopelessly lost and, once the panel is out of the way on Thursday afternoon, I’m looking forward to that random walk.
But that disoriented feeling is a frightening everyday experience for many people living with degenerative diseases, even in their own homes – Navigating the twilight years: Supporting older adults’ orientation and wayfinding in senior living facilities.
Wayfinding is a problem-solving process that demands processing power, which is why you’re more likely to get lost when you’re stressed – Decoding wayfinding: analyzing wayfinding processes in the outdoor environment.
Your ability to find your way around gets worse with age – Wayfinding in Interior Environments: An Integrative Review, and is a declining skill for people living with dementia, making it harder for them to move around freely – Wayfinding behavioral patterns of seniors with dementia: two exploratory case studies.
We navigate through a sequence of behaviours: move, stop and look/check, decide, then move again.
Simple tricks like placing a brigher light source in the direction you wish to guide an audience will help – The Movement of People toward Lights.
But if you’re designing lighting for a complicated layout like a trade fair – or a care home, understanding how the brain retains landmarks will help to optimise the solution.
There are three broad types: Turn left where you felt unhappy: how affect influences landmark-based wayfinding.
1. Structural salience – in a prominent position at crossroads or decision point – traditionally the location for street lamps and signs. Interestingly, when these high-visibility locations are too cluttered or too bright, they lose their wayfinding value – Optimal luminance of internally illuminated wayfinding signs.
2. Visual salience – size, shape, colour and contrast and position relative to the viewer – objects in the upper part of the visual field tend to attract more attention than those lower down towards the floor – Upper visual field advantage in object detection. Lighting to project shadows can effectively increase perceived scale and grab attention – but can also prove problematic for older adults who may process shadows as objects.
3. Cognitively salient landmarks – those that carry meaning for you, the viewer. Interestingly, while anything that triggers a strong emotion is more memorable than a neutral one, those with negative salience are more memorable than those with positive ones – Turn left where you felt unhappy: how affect influences landmark-based wayfinding.
Grand National day!
I will always remember sitting in the living room on a sunny afternoon with my grandparents placing penny bets on this celebrated race. Given my very bouncy experience of being on horseback, I often wondered how those riders kept their eyes on the prize while thundering along at breakneck speed.
And now I know!
The distinctive crouching position means they’re only moving vertically by around 6cm, less than half of the 15cm movement of the horse. One geeky fact – when riders shifted from the original upright position with long stirrups to that racing crouch, times went down by 7-10%!
The jockey’s brain is keeping a stable image on the retina by harnessing a remarkable mechanism called the ‘vestibular-ocular reflex’ that makes the eyes move to compensate for head movements, detected by the inner ear – Types of Eye Movements and Their Functions. You’ll see that effect if you look at yourself in the mirror and turn your head to one side – your eyes stay locked on your face while your head shifts.
But they are really just looking out for the next jump and letting their visual memory do the rest. The best riders fix their eyes on the jump earlier and for longer than the rest of the pack – Keeping Your Eye on the Rail: Gaze Behaviour of Horse Riders Approaching a Jump, and build a detailed visual map of the course that improves performance and reduces risk of accidents, too – The relationship between visual memory and rider expertise in a show-jumping context.
I’m off to place my bet!