Comparison of the efficacy of aroma-acupressure and aromatherapy for the treatment of dementia-associated agitation

Abstract

BackgroundOne of the most common symptoms observed in patients with dementia is agitation, and several non-pharmacological treatments have been used to control this symptom. However, because of limitations in research design, the benefit of non-pharmacological treatments has only been demonstrated in certain cases. The purpose of this study was to compare aroma-acupressure and aromatherapy with respect to their effects on agitation in patients with dementia.MethodsIn this experimental study, the participants were randomly assigned to three groups: 56 patients were included in the aroma-acupressure group, 73 patients in the aromatherapy group, and 57 patients in the control group who received daily routine as usual without intervention. The Cohen-Mansfield Agitation Inventory (CMAI) scale and the heart rate variability (HRV) index were used to assess differences in agitation. The CMAI was used in the pre-test, post-test and post-three-week test, and the HRV was used in the pre-test, the post-test and the post-three-week test as well as every week during the four-week interventions.ResultsThe CMAI scores were significantly lower in the aroma-acupressure and aromatherapy groups compared with the control group in the post-test and post-three-week assessments. Sympathetic nervous activity was significantly lower in the fourth week in the aroma-acupressure group and in the second week in the aromatherapy group, whereas parasympathetic nervous activity increased from the second week to the fourth week in the aroma-acupressure group and in the fourth week in the aromatherapy group.ConclusionsAroma-acupressure had a greater effect than aromatherapy on agitation in patients with dementia. However, agitation was improved in both of the groups, which allowed the patients with dementia to become more relaxed. Future studies should continue to assess the benefits of aroma-acupressure and aromatherapy for the treatment of agitation in dementia patients.Trial registrationChiCTR-TRC-14004810; Date of registration: 2014/6/12

Primary Care Physician Perspectives about Antipsychotics and Other Medications for Symptoms of Dementia

“…7 For example, an agitated patient can often be calmed by music, touch, and aromatherapy, especially in combination with other personalized approaches, whereas those who are hallucinating are more likely to need medication as part of the treatment plan. 7,9,[13][14][15] At times even optimally applied nonpharmacologic therapies simply do not work because of numerous factors, including disease variation and progression. 8,16 Medications used "off label" for BPSD include anxiolytics, antidepressants, cognitive enhancers, antipsychotics, and anticonvulsant mood stabilizers.…”

Non-Pharmalogical Interventions towards Behavioural and Psychological Symptoms of Dementia—An Integrated Literature Review

“…Aromatherapy with lavender oil in another study, however, showed improvements in agitation, the treatment made people with dementia more relaxed and that reduced the symptom. However, aromatherapy in combination with acupressure had an even greater effect [23]. Aromatherapy in combination with massage has been shown to give a significant difference in depressive symptoms in comparison to the standardized control group.…”

“…Regarding the symptom of agitation, aromatherapy combined with massage overall did not improve over a lengthy period, however, differences were detected within 24 hours after intervention during certain weeks of the intervention. The conclusion was that aromatherapy in combination with massage can be an effective and safe intervention for specific agitated behaviors and depression in individuals with dementia [23]. …”

“…However, acupressure gave greater effect to the symptoms than massage, indicating that acupressure is a more effective intervention [22]. Acupressure combined with lavender oil has shown significant results in reducing agitation, agitation decreased after first treatment and lasted three weeks after intervention [23]. In another study, the researchers tested the comparison of foot massage with a person sitting alone with the person in a room without speaking (quiet presence) of agitation in people with dementia.…”

Characteristic Autonomic Nervous Activity of Institutionalized Elders with Dementia

“…Passive and interactive music interventions were also found to cause short-term parasympathetic dominance [16]. Aroma therapy, a passive intervention, was also found effective in activating HF, tending to create a relaxed state in the elderly person [18]. Using heart rate variability (HRV) analysis, five minutes of music therapy revealed that activation of HF power.…”