282 Perspectives in Public Health l November 2012 Vol 132 No 6 Copyright © Royal Society for Public Health 2012 SAGE Publications ISSN 1757-9139 DOI: 10.1177/1757913911422288 Therapeutic lighting design for the elderly: A review PEER REVIEW Therapeutic lighting design for the elderly: a review Authors Shariful Shikder School of Civil and Building Engineering, Loughborough University, Leicestershire, LE11 3TU, UK Email: s.h.shikder@lboro. ac.uk Monjur Mourshed School of Civil and Building Engineering, Loughborough University, UK Andrew Price School of Civil and Building Engineering, Loughborough University, UK Corresponding author: Shariful Shikder, as above Keywords lighting design; elderly; biological effects; built environment Abstract Aims: Research suggests that specialised lighting design is essential to cater for the elderly users of a building because of reduced visual performance with increased age. This review aims to document what is known of the physical and psychological aspects of lighting and their role in promoting a healthy and safe environment for the elderly. Methods: A methodical review was carried out of published literature on the physical and psychological impacts of light on the elderly. Design standards and guides from professional organizations were evaluated to identify synergies and gaps between the evidence base and current practice. Results: Lighting has been identified as a significant environmental attribute responsible for promoting physical and mental health of the elderly. The evidence related to visual performance was found to be robust. However, guides and standards appeared to have focused mostly on illumination requirements for specific tasks and have lacked detailed guidelines on vertical lighting and luminance design. This review has identified a growing body of evidence on the therapeutic benefits of lighting and its use in treating psychological disorders among the elderly. The experiments using light as a therapy have improved our understanding of the underlying principles, but the integration of therapeutic aspects of lighting in design practice and guidelines is lacking. Conclusions: While design guidelines discuss the physical needs of lighting for the elderly fairly well, they lack incorporation of photobiological impacts. Despite positive outcomes from research, the implementation of therapeutic aspects of lighting in buildings is still debatable due to insufficient relevant investigations and robustness of their findings. Collaborations between designers and physicians can contribute in delivering customised lighting solutions by considering disease types and needs. Further investigation needs to be carried out for translating therapeutic benefits to photometric units to implement them in building lighting design. INTRODUCTION The median age of Britain’s population has increased over the past few decades due to a significant rise in life expectancy. The population aged 65 and over has increased by 1.7 million over the last 25 years and constitutes 16% of the total population. 1 This trend is projected to continue and by 2034, 23% of the population will be aged 65 and over, compared to 18% being aged under 16. A similar trend in demographics is also present in other European countries. 2 In the USA, the elderly population aged over 65 increased from 3 million to 33 million between 1900 and 1994. 3 The number in this age group is projected to increase from 39 million in 2010 to 72 million in 2030, which will constitute 20% of the total population compared to 13% at present. 4 The ageing population has already been recognised as one of the greatest challenges of the 21st century for housing. 5,6 The existing housing stock in the UK, the quality of which has been highlighted by the Homes and Communities Agency as insufficient to meet elderly living criteria, 7 needs to be updated. In addition, sufficient appropriate housing needs to be made available in future to relieve the forecasted unsustainable pressures on homes. Apart from houses, workplaces and other facilities need to be refurbished and new ones built to