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Aromatherapy in dementia

In a recent consensus statement by the British Psychopharmacological Association 1 the use of aromatherapy as a supplement to the pharmacological treatment of dementia is supported by one of the highest scientific evidence – evidence from randomized controlled trials [19659002] A number of fresh, verified studies have shown that aromatherapy (Lavandula angustifolia or Lavandula officinalis) and lemongrass (Melissa officinalis) are two of the most important oils in this area. The purpose of Holmes & Ballard's article 2 here is to review published reports on aromatherapeutic efficacy in the treatment of behavioral problems of people with dementia

. The results of these studies are interesting because our findings can not be as noted by authors, most people with severe dementia have lost their sense of smell because of the early loss of odor neurons.3 In fact, the pharmacological mechanism with which the effect of aromatherapy does not require the perception of odor. Instead, it is thought that the active compounds get into the body (through the lungs or smells through absorption through mucous membranes) and reach the brain through the bloodstream where they act directly

Aromatherapy in patients with dementia Many small uncontrolled case studies have shown inhaled and / or topical lavender oil in this environment. In summary, these studies have shown that lavender oil improves sleep patterns, 4-7, and improves behavior.8,9

Although only a few of the studies studied the potential use of aromatherapy to treat behavioral problems dementia, the results were positive. One blind, case study examined the effects of lavender essential oils on abnormal behavior of patients with severe dementia.10,11 Patients (n = 21) were randomized to receive only a massage, lavender essential oil, massage or lavender oil inhalation and conversation. Of the three patients who received the essential oil in a massage, the frequency of excessive motor behavior was significantly reduced.

In a small (n = 15) double-blind, placebo-controlled, severe dementia, 11.12 2% lavender oil in the NHS care class was administered for 2 hours in the classroom aroma diffuser, alternately with placebo (water) every other day , for a total of ten treatments. According to the Pittsburgh agitation scale, lavender aromatherapy treatment in patients with severe dementia significantly reduced mixed behavior compared to placebo (p = 0.016) and 60% of patients experienced some improvement. No adverse events reported and compliance with therapy were 100%

In a crossover trial, fourteen essential oils (lavender, sweet marjoram, patchouli and vetiver) or cream were harvested in 13 56 older, moderately severe or severe dementia, alone five times for 8 weeks . Behavioral problems and resistance to treatment were significantly lower in patients who received the cream containing essential oils compared to those who only received the cream

The largest double-blind, placebo-controlled study published at the time of the review , 11.14 72 patients with severe dementia have been randomly assigned to the NHS for continuous care of citric acid balm essential oil (n = 36) or sunflower oil (n = 36) as psychotropic drugs. Clinically significant changes have been observed by comparing the Cohen-Mansfield Agitation Inventory [CMAI] and the quality of life indexes between the two groups during the 4-week treatment. The CMAI score decreased by 30% in 60% of the active treatment group and 14% in the control group. The mean reduction in CMAI score was 35% in lemon treated patients compared to 11% of placebo-treated patients (pMethodological questions

). In their paper, Holmes & Ballard2 draws attention to a number of methodological questions to be considered in the design of future studies on aromatherapy in the clinical management of behavioral and psychiatric symptoms of people suffering from dementia

. Although most people with severe dementia have little sense of smell, the test may attempt to identify the examined essential oil, which could jeopardize the double-blind test. This problem can be overcome in many ways, such as the use of monitoring measures in the primary outcome of the test or nose clip at the participants' with the fragrances regulating the environment and e. In addition, since a large number of placebo reactions have been observed in the treatment of behavioral or psychiatric symptoms of people suffering from dementia, it is important in studies of essential oils that essential oils control and aromatherapy interventions take similar amounts of time and contact themselves for each participant.

Holmes & Ballard2 find that although many case studies prove the effectiveness of aromatherapy due to sleep, agitated behavior and improved resistance to dementia, there is no adequate placebo-controlled, randomized study in this area. Although a placebo-controlled study has shown that aromatherapy contributes to the treatment of dementia patients, this study included many methodological errors.

The authors identify many important issues that need to be addressed in the research of the efficacy of aromatherapy among patients with dementia including:

  • Patients with different forms of dementia react differently to pharmacologic agents; whether the same is true of their response to aromatherapy.
  • Essential oils are given in a variety of "carriers" (eg skin care creams, massage oils) and therefore include "complementary therapies" for physical contact. Obviously, this additional therapies need to be minimized or controlled before direct conclusions on the effects of aromatherapy can be deduced.
  • If it is accepted that there are active neurochemical differences between essential oils, then research should not only investigate the oils (eg Lavandula angustifolia and Lavandula officinalis)
  • Properly designed, well-designed, randomized, verified examinations are required before definitive conclusions on the efficacy and safety of essential oils can be deduced.

References

  1. Burns A, O & Brien J; BAP Dementia Consensus Group. Clinical Practice with Deny Drugs: A Consensus Statement by the British Psychopharmacological Association. Journal of Psychopharmacology 2006, 20: 732-55.
  2. Holmes C, Ballard C. Aromatherapy in dementia. Advances in Psychiatric Treatment 2004; 10: 296-300
  3. Vance D. With regard to the odorless irritation of adults with aging dementia. Perceptual and Motor Skills 1999, 88: 398-400
  4. Henry J., Rusius CW, Davies M. et al. Lavender for nighttime sedation of demented people. International Journal of Aromatherapy 1994; 5: 28-30.
  5. West BJM, Brockman SJ. The soothing power of aromatherapy. Journal of Dementia Care 1994, 2: 20-2.
  6. Hardy M, Kirk-Smith M, Stretch D. Replacing the drug treatment of the insomnia with environmental odor. Lancet 1995, 346: 701.
  7. Wolfe N, Herzberg J. Can aromatherapy oils promote sleep in severe dementia patients? International Journal of Geriatric Psychiatry 1996, 11: 926-7.
  8. Brooker DJR, Snale M, Johnson et al. A unique assessment of the effects of aromatherapy and massage on the discomfort in severe dementia. British Journal of Clinical Psychology 1997, 36: 287-96.
  9. MacMahon S, Kermode S. Clinical study of the effects of aromatherapy in the care of dementia in motivational behavior as a single subject. Australian Journal of Holistic Nursing 1998; 52: 47-9.
  10. Smallwood J, Brown R, Coulter F et al. Aromatherapy and behavioral disorders in dementia: randomized, verified examination. International Journal of Geriatric Psychiatry 2001; 16: 1010-13
  11. Burns A, Byrne J, Ballard et al. Sensitive pacing in dementia. BMJ 2002, 325: 1312-15.
  12. Holmes C, Hopkins V, Hensford C et al. Lavender oil for treating agitated behavior in severe dementia. International Journal of Psychogeriatric Psychiatry 2001; 17: 305-8.
  13. Bowles EJ, Griffiths DM, Quirk L et al. The effects of essential oils and affect resistance to home care procedures and other dementia behaviors in residential institutions. International Journal of Aromatherapy 2002, 12: 22-9
  14. Ballard CG, O Brien JT, Reichelt K. et al. Aromatherapy as a safe and effective treatment for severe dementia: the results of a double-blind, placebo-controlled study in Melissa. Journal of Clinical Psychiatry 2002, 63: 553-8.
  15. Thorgrimsen L, Spector A, Wiles A, Orrell M. Aromatherapy aromatherapy. Cochrane database Systematic Reviews 2003; (3): CD003150
  • Published On : 2 months ago on March 17, 2018
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  • Last Updated : March 17, 2018 @ 7:30 pm
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