The present paper reviews the role of illumination in shaping the indoor environment of the elderly person. The approach is that lighting has a twofold impact on the individual. One is as a source of information about the environment, i.e., visual, and the other is photobiological through the skin or photoreceptor.
The visually lighted environment is reviewed, discussing first the physiological changes that occur during the aging process, then the effect of aging on visual performance, and finally the importance of qualitative factors in assessing the adequacy of an illuminated environment for the elderly. Special attention is given to application problems in lighting for the elderly, i.e., excessive brightness differences, discomfort glare, veiling reflections, and the importance of color and the spectral power distribution of the light source. The advantages of a full-spectrum light source which simulates natural sunlight for indoor illumination is discussed in light of recent research.
The biologically lighted environment is reviewed in terms of the potential role that indoor illumination can play in regulating important biochemical processes in the elderly population, i.e., neuroendocrine control, vitamin D3 synthesis, immunologic mechanisms, and cardiovascular regulation.
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References
1.
Aaron, J. E., Gallagher, J. C., and Nordin, B. E. C.Seasonal variation of historical osteomalacia in femoralneck fractures. Lancet, 1974, 2, 84–85.
2.
Allen, R. M. and Cureton, T. K.Effect of ultraviolet radiation on physical fitness. Archives of Physical Medicine and Rehabilitation, 1945, 26, 641–644.
3.
Alpern, M.Effects of illuminance quantity on accommodation of the eyes. Industrial Medicine and Surgery, 1958, 27 (11), 551–556.
4.
Aston, S. M. and Bellchambers, H. E.Illumination, colour rendering, and visual clarity. Lighting Research and Technology, 1969, 1, 259–261.
5.
Bauer, W., Aub, J. C., and Albright, F.Studies of calcium and phosphorus metabolism. VA study of the bone trabeculae as a readily available reserve supply of calcium. Journal of Experimental Medicine, 1929, 49, 145–166.
6.
Bennett, C. A.The demographic variables of discomfort glare. Lighting Design and Application, 1977, 7, 22–24.
7.
Blackwell, O. M. and Blackwell, H. R.IERI report: Visual performance data for 186 normal observers of various ages. Journal of the Illuminating Engineering Society, 1971, 1, 2–13.
8.
Blackwell, H. R., and Scott, D. C.Analysis of visual performance data obtained in a landolt ring task without response limitation. Illuminating Engineering, 1973, 2, 445.
9.
Boettner, E. A. and Wolter, J. R.Transmission of ocular media. Investigative Ophthalmology, 1962, 1, 776–783.
10.
Boyce, P. R.Investigations of the subjective balance between illuminance and lamp colour properties. Lighting Research and Technology, 1977, 9, 11–24.
11.
Boyce, P. R. and Simons, R. H.Hue discrimination and light sources. Lighting Research and Technology, 1977, 9, 125–140.
12.
Boynton, R. M., Corwin, T. R., and Sternheim, C.Visibility losses produced by Rash adaptation. Illuminating Engineering, 1970, 65, 259.
13.
Committee on Nutrition, American Academy of Pediatrics. The prophylactic requirement and the toxicity of vitaminD. Pediatrics, 1963, 31, 513–525.
14.
Dale, A. E. and Lowenberg, M. E.Consumption of vitamin D in fortified and natural foods and in vitamin preparations. Journal of Pediatrics, 1967, 70, 952.
15.
Dantsig, N. M., Lazarev, D. N., and Sokolov, M. V. Ultraviolet installations of beneficial action. CIE publication P 67.20, 1967.
16.
Delvin, E. E., Bourbomais, R., and Glorieux, F. S.The measurement of circulating 25-hydroxymetabolites of vitamin D2, and D3 in human serum: Effect of the anticonvulsant drugs. Clinical Research, 1976, 25, 657 A.
17.
Dorney, R. C., McFarland, R. A., and Chadwick, E.Dark adaptation as a function of age and time: II. A derivation. Journal of Gerontology, 1960, 15, 267–279.
18.
Duke-Elder, W. S. (Ed.) The physiology of the eye of vision. System of Ophthalmology, Volume 4, St. Louis: C. V. Mosby, 1968.
19.
Duke-Elder, W. S.Text-book of ophthalmology, Volume 2. St. Louis: C. V. Mosby, 1938.
20.
Eastman, A. A.A new contrast threshold visibility meter. Illuminating Engineering, 1968, 63, 37–42.
21.
Ellinger, F.Medical radiation biology.Springfield, IL: Charles C. Thomas, 1957.
22.
Ferree, C. E. and Rand, G.The effect of the intensity of illumination on the near point of vision and a comparison of the effect for presbyopic and non-presbyopic eyes. Transactions of the Illuminating Engineering Society, 1933, 27, 590.
23.
Fisher, J. A. and Christie, A. W.A note on disability glare. Vision Research, 1965, 5, 565–567.
24.
Foridez, C., Barras, C., and Garcia, B.Contribution à l'étude des deficiences en vitamin D chez subjets âgés. Schweizerische Medizinische Wochenscrift, 1977, 107, 764–768.
25.
Fozard, J. L. and Popkin, S. J.Optimizing adult development: Ends and means of an applied psychology of aging. American Psychologist, 1978, 33, 975–989.
26.
Fry, G. A.A re-evaluation of the scattering theory of glare. Illuminating Engineering, 1954, 49, 98–102.
27.
Gallagher, J. C., Riggs, B. L., Eisman, J., Arnaud, S. B., and DeLuca, H. F.Impaired production of 1,25-dihydroxvitamin D in post-menopausal osteoporosis. Clinical Research, 1976, 24, 580A.
28.
Garrison, L. M., Murray, L. E., Doda, D. D., and Green, A. E. S.Diffuse-direct ultraviolet ratios with a compact double monochromator. Applied Optics, 1978, 17, 827–836.
29.
Garrison, L. M., Murray, L. E., and Green, A. E. S.Ultraviolet limit of solar radiation at the earth's surface with a photon counting monochromator. Applied Optics, 1978, 17, 683–684.
30.
Gerard, R. M. Differential effects of colored lights on psychophysiological functions. Unpublished doctoral dissertation, University of California at Los Angeles, Los Angeles, CA, 1958.
31.
Grandjean, E.Fitting the task to the man.London: Taylor and Francis, Ltd., 1969.
32.
Gray, R. W., Caldas, A. E., Adams, N. D., and Lemann, J. R., Jr.Calcium and plasma, 1.25-(OD)2D-vitamin D in health. Clinical Research, 1977, 25, 621A.
33.
Guth, S. K. and Eastman, A. A.Footcandles for the forgotten man illuminatingEngineering, 1956, 51, 251–258.
34.
Hardy, A. C.A case for reduced window areas. International Lighting Review, 1974, 25, 90–92.
35.
Hartridge, H.Color receptors of the human fulvia. Nature (London), 1946, 158, 97–98.
36.
Hartridge, H.Recent advances in the physiology of vision, London: Churchill, 1950.
37.
Herman, R. H. (Ed.) American Journal of Clinical Nutrition, 1976, 29, 1183–1330.
38.
Horsman, A., Gallagher, J. C., Simpson, M., and Nordin, B. E. C.Prospective trial of oestrogen and calcium in postmenopausal women. British Medical Journal, 1977, 2, 789–792.
39.
Hughes, P. C.The contribution of lighting to productivity and quality of work life. Paper presented at the Institute of Electrical and Electronics Engineers, Industry Applications Society, Los Angeles, June, 1977.
40.
Hughes, P. C. and McNelis, J. F.Lighting, productivity and the work environment. Paper presented at the Annual Illuminating Engineering Society Technical Meeting, Denver, August, 1978.
41.
Ireland, P. and Fordtran, J. S.Effect of dietary calcium and age on jejunal calcium absorption in humans studied by intestinal perfusion. Journal of Clinical Investigation, 1973, 52, 2672–2681.
42.
Ivey, H. F.Color and efficiency of luminescent light sources. Journal of the Optical Society of America, 1963, 53, 1185–1198.
43.
Judd, D. B., MacAdam, D. L., and Wyszecki, G.Spectral distribution of typical daylight as a function of correlated color temperature. Journal of the Optical Society of America, 1964, 54, 1031.
44.
Kaufman, J. E. (Ed.) IES lighting handbook (5th ed.) New York: Illuminating Engineering Society, 1972.
45.
Kolomiytseva, M. G., Voznesenskaya, E. A., Isayeva, E. A., and Generalov, A. A.Role of ultraviolet radiation in increasing natural resistance of the animal organism when associated with different amounts of copper and manganese in the daily ration. Journal of Hygiene, Epidemiology, Microbiology and Immunology, 1972, 16, 240–246.
46.
Kunitsyna, L. A., Yezhova, V. A., Cerfus, I. S., Pertsovskiy, A. I., and Sarzhisko, Y. M.Clinical-physiological basis for application of longwave ultraviolet irradiation in the complex therapy of patients with early cerebral atherosclerosis with temporary disturbance of cerebral circulation. Voprosy Kurortologii, Fizioterapii i Lechebnoi Fizicheskoi Kultury, 1977, 5.
47.
Kushnir, Y. V. and Okhon 'ko.Effect of total ultraviolet irradiations on the status of the neurohumoral regulation in patients with ulcer. Vrochebnoye Delo, 1977, 1, 65–67.
Lemons, T. M. and Robinson, A. V.Does visual clarity have meaning for IES illumination recommendations for task lighting?Lighting Design and Application, 1976, 6, 24–28.
50.
Luckiesh, M. and Moss, F. K.Visibility, its measurement and significance in seeing. Journal of the Franklin Institute, 1935, 220, 431–440.
51.
Maas, J. B., Jayson, J. K., and Kleiber, D. A.Effects of spectral difference in illumination on fatigue. Journal of Applied Psychology, 1974, 59, 524–526.
52.
Maim, O. J.Calcium requirement and adaptation in man. Scandinavian Journal of Laboratory and Clinical Investigation, 1958, 10, Suppl. 36.
53.
McNelis, J. F., Williams, H. G., and Henderson, R. L.A survey and analysis of important visual tasks in offices. Lighting Design and Applications, 1975, 5, 16–24.
54.
National Center of Health Statistics. Monocular visual acuity of persons 4-74 years. Washington, DC: Department of Health, Education, and Welfare, DHEW Publication No. (HRA) 77-1646, 1977.
55.
Neer, R., Clark, M., Friedman, V., Belsey, R., Sweeney, M., Buonchristiani, J., and Potts, J. R., Jr.Environmental and nutritional influences on plasma 25-hydroxyvitamin D concentration and calcium metabolism in man. Vitamin D-biochemical, chemical and clinical aspects related to calcium metabolism.Berlin, NY: Walter de Gruyter, 1977.
56.
Neer, R. M., Davis, T. R. A., Walcott, A., Koski, S., Schapis, P., Taylor, I., Thorington, L., and Wurtman, R. J.Stimulation by artificial lighting of calcium absorption in elderly human subjects. Nature, 1971, 229, 255 (and unpublished observations).
57.
Nickerson, D. and Jerome, C. W.Color rendering of light sources: CIE method of specification and its application. Illuminating Engineering, 1965, 60, 263.
58.
Norman, A. W., Schaefer, K., Coburn, J. W., DeLuca, H. F., Fraser, D., Grigoleit, H. G., and Herrath, D. V. (Eds.) Vitamin D---Biochemical, chemical and clinical aspects related to calcium metabolism: Proceedings of the 3rd Workshop on Vitamin D, Asilomar, Pacific Grove, CA, January, 1977. Berlin, NY: Walter de Gruyter, 1977.
59.
Ostberg, O., Stone, P. T., and Benson, R. A.Free magnitude estimation of discomfort glare and working task difficulty. Goteburg Psychological Reports, 1975, 5, 1–18.
60.
Parry, E. S. and Lister, I. S.Sunlight and hypercalciuria. Lancet, 1975, 1, 1063–1065, and personal communication.
61.
Peacock, M., Gallagher, J. C., and Nordin, B. E. C.Action of 1α hydroxyvitamin D3 on calcium absorption and bone resorption in man. Lancet, 1974, 1, 385–389.
62.
Pertsovskiy, A. I. and Kunitsyna, L. A.Biochemical assessment of the effectiveness of different ultraviolet irradiation modes on patients with cerebral atherosclerosis. Vopr Kurortol Fizioter Lech Fiz Kult, 1977, 3, 821.
63.
Phang, J., Berman, M., Finerman, G. A., Neer, R. M., Rosenberg, L. E., and Hahn, T. J.Dietary perturbation of calcium metabolism in normal man: Compartmental analysis. Journal of Clinical Investigation, 1969, 48, 67–86.
64.
Pike, J. W., Toverud, S., Boass, A., McCain, T., and Haussler, M. R.Circulating 10d, 25---(OH)2D during physiologic states of calcium stress. Vitamin D---Biochemical, chemical and clinical aspects related to calcium metabolism.Berlin, NY: Walter de Gruyter, 1977, 187–189.
65.
Plank, J. J. and Schick, J.The effects of color on human behavior. Journal of the Association for Study in Perception, 1974, 9, 4–16.
66.
Potts, J. R., Jr., and Deftos, L. J.Parathyroid hormone, calcitonin, vitamin D, bone and bone mineral metabolism. Duncan's diseases of metabolism (7th ed.), Philadelphia: W. B. Sanders Co., 1974, 1225–1430.
67.
Purvis, R.J., Mackay, J.S., Cockburn, F., Barrie, W.J. McK., Wilkinson, E. M., Belton, N. R., and Forfar, J. O.Enamel hypoplasia of the teeth associated with neonatal tetany: A manifestation of material vitamin D deficiency. Lancet, 1973, 2, 811–814.
68.
Recker, R. R., Saville, P. D., and Heaney, R. P.Effect of estrogens and calcium carbonate on bone loss in postmenopausal women. Annals of Internal Medicine, 1977, 87, 649–655.
69.
Rex, C. H. and Franklin, J. S.Relative visual comfort evaluations of roadway lighting. Illuminating Engineering, 1960, 55 (3), 161–168.
70.
Roberts, S. A., Cohen, M. D., and Forfar, J. O.Antenatal factors associated with neonatal hypocalcemic convulsions. Lancet, 1973, 2, 809–811.
71.
Scotton, J., Fears, T. R., and Gori, G. B.Measurements of ultraviolet radiation in the United States and comparisons with skin cancer data. U.S. Department of Health, Education, and Welfare, DHEW Publication No. (NIH) 76-1029, 1975.
72.
Sharon, I. M., Feller, R. P., and Burney, S. W.The effects of lights of different spectra on caries incidence in the golden hamster. Archives of Oral Biology, 1971, 16, 1427–1432.
73.
Shen, F. H., Baylink, D. J., Nielsen, R. L., Sherrard, D. J., Ivey, J. L., and Haussler, M. R.Increased serum 1,25-dehydroxy vitamin D in idiopathic hypercalciuria. Journal of Laboratory and Clinical Medicine, 1977, 90, 955–962.
74.
Thorington, L.Light, biology, and people. Lighting Design and Application, 1973, 3, 31–36.
75.
Thorington, L. and Parascandola, L. J.Ultraviolet emission from light sources used as general illuminants. Illuminating Engineering, 1967, 62, 674–681.
76.
Thorington, L., Parascandola, L., and Cunningham, L.Visual and biologic aspects of an artificial sunlight illuminant. Journal of the Illuminating Engineering Society, 1971, 1, 33–41.
77.
U.S. Department of Health, Education, and Welfare, National Center for Health Statistics. Monocular visual acuity of persons 4-74 years. Author, DHEW Publication No. (HRA) 77-1646, 1971-1972.
78.
Volkova, N. V.Experience in the use of erythemic radiation in the general lighting system of a machine shop. Gigiena i Sanitariia, 1967, 32, 109–111.
79.
Wake, T., Kikuchi, T., Takeichi, K., Kasama, M., and Kamisasa, H.The effects of illuminance, color temperature and color rendering index of light sources upon comfortable visual environments-In the case of an office. Journal of Light and Visual Environment, 1977, 1(2), 31–39.
80.
Weale, R. A.Retinal illumination and age. Transactions of the Illuminating Engineering Society, 1961, 26, 95.
81.
Wcale, R. A.The aging eye.New York: Harper & Row, 1963.
82.
Weale, R. A.Illumination levels in the United Kingdom. The occupational safety and health effects associated with reduced levels of illumination. Cincinnati: USDHEW Center for Disease Control, DHEW (NIOSH) Publication No. 75-142, March, 1975.
83.
Weston, H. C.Illumination and the variation of visual performance with age. Proceedings of the International Commission on lllumination. Stockholm, 1951.
84.
Weston, H. C.Sight, light and efficiency.London: H. K. Lewis, 1949.
85.
Withrow, R. B. and Withrow, A. P.Generation, control and measurement of visible and near-visible radiant energy. Radiation biology, Vol. 3. New York: McGraw-Hill, 1956.
86.
Wolff, E.Glare and age. Archives of Ophthalmology, 1960. 64, 502–514.
87.
Wurtman, R. J.Effects of light and visual stimuli on endocrine function. In L. Martini and W. F. Ganong (Eds.) Endocrinology.New York: Academic Press, 1967.
88.
Wurtman, R. J.The effects of light on man and other mammals. Annual Review of Physiology, 1975, 37, 467–483. (a)
89.
Wurtman, R. J.The effects of light on the human body. Scientific American, 1975, 233 (1), 68–77. (b)
90.
Wurtman, R. J. and Neer, R. M.Good light and bad. New England Journal of Medicine, 1970, 282, 394–395.
91.
Wurtman, R. J. and Weisel, J.Environmental lighting and neuroendocrine function: Relationship between spectrum of light source and gonadal growth. Endocrinology, 1969. 85, 1218–1221.
92.
Zamkova, M. A. and Krivitskaya, E. I.Effect of irradiation by ultraviolet erythema lamps on the working ability of school children. Gigiena i Sanitariia, 1966, 41–44.
93.
Zatuchny, A. I.Summaries of papers of the Kharkov Medical Institute and of the departmental conference held on the occasion of the 150th anniversary of the institute. Kharkov: Kharkov Medical Institute, 1955.
