1. Non-pharmacological approaches for dementia that informal carers might try or access: a systematic review.

Hulme C, Wright J, Crocker T, Oluboyede Y, House A.




Academic Unit of Health Economics, Leeds Institute of Health Sciences, University of Leeds, UK. c.t.hulme@leeds.ac.uk



To review non-drug treatments for dementia; to provide a source of evidence for informal carers who want ideas about non-drug approaches for dementia, that they might try or that they could try to access. The systematic review addresses: what non-drug treatments work and what do they work for? What non-drug treatments might work and what for? What non-drug treatments do not work?


Literature searches of seven electronic databases (AMED, CINAHL, EMBASE, MEDLINE, PSYCINFO, Cochrane Library of Systematic Reviews and DARE) were carried out in November 2007 using the following search terms (or derivatives): dementia/Alzheimer's AND Review AND non-drug therapies and aimed at finding systematic reviews.


Thirty-three reviews were identified; 25 were judged to be high or good quality. Studies within these systematic reviews were characterised by weak study designs with small sample numbers. Three interventions were found to be effective for use with particular symptoms of dementia: music or music therapy, hand massage or gentle touch and physical activity/exercise.


Whilst informal carers can apply some of the interventions highlighted in the home setting at little or no cost to themselves or to health or social care services, others are likely to require training or instruction. Service providers and commissioners should explore current and future provision of more structured group activities for people with dementia; in particular the provision of group music therapy and group exercise activities that meet the needs of both the person with dementia and their carer.

(c) 2009 John Wiley & Sons, Ltd.

PMID: 19946870

[PubMed - indexed for MEDLINE]


2. Craniosacral still point technique: exploring its effects in individuals with dementia.

Gerdner LA, Hart LK, Zimmerman MB.


Center for Education in Family and Community Medicine, Department of Medicine, Stanford University, Palo Alto, California, USA. lgerdner@gmail.com


A mixed methodology was used to explore the effects of craniosacral still point technique (CSPT) in 9 older adults with dementia. Participants were monitored at baseline (3 weeks), intervention (6 weeks), and postintervention (3 weeks) using the modified Cohen-Mansfield Agitation Inventory (M-CMAI). CSPT was implemented daily for 6 weeks by a certified craniosacral therapist. Findings indicated a statistically significant reduction in M-CMAI total and subscale scores during the intervention period. This reduction continued during postintervention for subscale scores of physical nonaggression and verbal agitation. Staff and family interviews provided convergent validity to the quantitative findings. Participants were also more cooperative during caregiving activities and displayed meaningful interactions.

PMID: 18350746

[PubMed - indexed for MEDLINE]


3. The effect of lavender aromatherapy on cognitive function, emotion, and aggressive behavior of elderly with dementia.

[Article in Korean]

Lee SY.




Department of Nursing, Kongju National University, Korea. sylee601@kongju.ac.kr



This study was to develop an aromatherapy hand massage program, and to evaluate the effects of lavender aromatherapy on cognitive function, emotion, and aggressive behavior of elderly with dementia of the Alzheimer's type.


The Research design was a nonequivalent control group non-synchronized quasiexperimental study. Lavender aromatherapy was administrated to experimental group I for 2 weeks, jojoba oil massage was administrated to experimental group II for 2 weeks, and no treatment was administrated to the control group for 2 weeks. Data was analyzed using the chi(2)-test, ANOVA, repeated measures of ANCOVA and ANCOVA in the SPSS program package.


1. Experimental group I did not show significant differences in cognitive function in relation to the experimental group II and control group. 2. Experimental group I showed significant differences in emotion and aggressive behavior in relation to the experimental group II and control group.


A Lavender aromatherapy hand massage program is effective on emotions and aggressive behavior of elderly with dementia of the Alzheimer's type.

PMID: 15860944

[PubMed - indexed for MEDLINE]


4. A controlled trial of aromatherapy for agitation in nursing home patients with dementia.

Snow LA, Hovanec L, Brandt J.




Houston Center for Quality of Care and Utilization Studies, Health Services Research and Development Service, Michael E.Debakey Veterans Affairs Medical Center, Houston, TX 77030, USA. asnow@bcm.tmc.edu



Two controlled trials of aromatherapy to decrease agitation in persons with dementia have recently produced promising results. However, both studies combined the use of essential oils with massage. Thus, it is unclear if the effect of the aromatherapy intervention was the result of smelling or the cutaneous absorption of the oils. The purpose of this study was to determine whether smelling lavender oil decreases the frequency of agitated behaviors in patients with dementia.


The study design was within-subjects ABCBA (A = lavender oil, B = thyme oil, C = unscented grapeseed oil): 4 weeks of baseline measurement, 2 weeks for each of the five treatment conditions (10-week total intervention time), and 2 weeks of postintervention measurement. Oil was placed every 3 hours on an absorbent fabric sachet pinned near the collarbone of each participant's shirt.


A long-term care facility specifically for persons with dementia.


Seven agitated nursing home residents with advanced dementia.


Agitation was assessed every 2 days using a modified Cohen-Mansfield Agitation Inventory. Olfactory functioning was assessed with structured olfactory identification and discrimination tasks, and with qualitative behavioral observation during those tasks.


Split-middle analyses conducted separately for each patient revealed no treatment effects specific to lavender, no treatment effects nonspecific to pleasant smelling substances, and no treatment effects dependent on order of treatment administration. There were no differences between participants with more and less intact olfactory abilities.


There is significant evidence in the neurologic and neuropsychologic literature that persons with dementia have impaired olfactory abilities. Concordant with this literature, this study found no support for the use of a purely olfactory form of aromatherapy to decrease agitation in severely demented patients. Cutaneous application of the essential oil may be necessary to achieve the effects reported in previous controlled studies.

Copyright Mary Ann Liebert, Inc.

PMID: 15253846

[PubMed - indexed for MEDLINE]