# A Pragmatic Crossover Trial to Test the Effectiveness of a Novel Lighting System to Reduce Nighttime Falls in Persons with Alzheimer’s Disease and Related Dementias

> **NIH NIH R01** · UNIV OF NORTH CAROLINA CHAPEL HILL · 2022 · $830,153

## Abstract

Project Summary/Abstract
Having Alzheimer's disease or a related dementia, being ambulatory, and awakening in the night constitute a
recipe for a dangerous fall. Add a lighting system that promotes postural stability, and the fall may be avoided.
That is exactly what our recent NIH R21 exploratory/developmental randomized crossover trial did, and exactly
what we found -- a 34% decrease in falls due to a novel lighting intervention. The proposed project will build on
that preliminary effort; if the results are as promising as suggested, this pragmatic passive lighting system has
the potential to reduce falls and related sequelae for countless persons with Alzheimer's disease and related
dementias, and to become a new standard of care.
Falls are the primary cause of fatal and non-fatal injuries among persons 65 years of age and older. Dementia
is a major risk factors for falls, and assisted living (AL) communities are the primary provider of residential care
for ambulatory older adults with dementia, making AL a critical setting in which to reduce falls. Forty-two
percent of the more than 811,000 AL residents across the U.S. have moderate or severe dementia, 84% are
ambulatory, and more than a third experience a fall in a six-month period, putting them among the 15% of AL
residents who suffer a hip fracture or other serious fall-related injury each year. Falls are responsible for one-
third of all hospitalizations of AL residents, and the resulting injuries may lead to a cascade of events, including
worsening function, nursing home transfer, and death.
A significant number of these falls occur in the bedroom during the evening and night, when AL staff are not
present, thereby limiting their ability to intervene. However, the cause of many of these falls -- impaired
nighttime vision and related postural instability -- suggests a promising avenue for intervention. Specifically, an
intervention that does not require staff effort, and that targets orientation and postural stability in the evening
and night when lighting is poor and residents may not be fully awake, has great potential to reduce falls in AL.
This project will test the effectiveness of a novel intervention consisting of unobtrusive, low-intensity, horizontal
and vertical lights that outline the bathroom or entry way doorframe in residents' rooms and provide visual cues
to promote postural stability. The lighting system is particularly attractive and pragmatic because it is low cost,
requires no staff involvement, and can be easily installed in new buildings or retrofitted to existing buildings.
Specifically, this pragmatic crossover trial will enroll 390 AL residents with dementia and follow them for one
year, comparing the incidence of nighttime falls during the lighting condition to the incidence of falls during the
control condition; secondarily, it will determine whether and to what extent the intervention effect is modified by
resident- and environmental-level risk factors, and sati...

## Key facts

- **NIH application ID:** 10342711
- **Project number:** 1R01AG075010-01
- **Recipient organization:** UNIV OF NORTH CAROLINA CHAPEL HILL
- **Principal Investigator:** Sheryl Zimmerman
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $830,153
- **Award type:** 1
- **Project period:** 2022-07-01 → 2027-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10342711

## Citation

> US National Institutes of Health, RePORTER application 10342711, A Pragmatic Crossover Trial to Test the Effectiveness of a Novel Lighting System to Reduce Nighttime Falls in Persons with Alzheimer’s Disease and Related Dementias (1R01AG075010-01). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10342711. Licensed CC0.

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