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R E S E A R C H

Aromatherapy Eases Agitation in Severe Dementia
Aromatherapy reduced agitation and increased constructive activity in people with severe dementia, according to a recent study.

"Aromatherapy as a Safe and Effective Treatment for the Management of Agitation in Severe Dementia: The Results of a Double-Blind, Placebo-Controlled Trial With Melissa" was conducted by Clive Ballard, M.D., John O'Brien, Katharina Reichelt and Elaine Perry, Ph.D., of Wolfson Research Centre, Newcastle General Hospital, Institute for Ageing and Health, in the United Kingdom.

Seventy-two people from eight nursing homes participated in the study. Selected subjects had agitation that was deemed clinically significant because it occurred at least once a day and caused moderate to severe management problems for the staff.

According to the study's authors, agitation was defined as "a cluster of symptoms including anxiety and irritability, motor restlessness, and abnormal vocalization."

The nursing homes were randomly assigned to use either placebo or active treatment. The placebo was sunflower oil added to a base lotion; the active treatment was Melissa essential oil added to a base lotion. The lotions were kept in opaque containers that delivered metered doses of .16 to .17 grams of lotion at a time.

A care assistant applied the lotion to the subject's face and arms twice a day, for a total of six doses per day, or 200 milligrams of oil.

Levels of agitation were measured on the Cohen-Mansfield Agitation Inventory (CMAI) every week for four weeks by raters blind to whether participants had received the active or placebo aromatherapy treatment.

"Aromatherapy with essential balm oil was well tolerated and resulted in a 35% improvement in agitation compared with an 11% improvement with placebo treatment, a highly significant difference," state the study's authors. "Restlessness and shouting were the domains with the greatest improvement."

Among the people receiving the active aromatherapy treatment there was also a significant increase in the amount of time spent involved in constructive activities, and a significant decrease in the amount of time spent socially withdrawn.

"This improvement indicates a benefit in overall well-being, in addition to the reduction in agitation, and suggests that improvements were not a consequence of increased sedation, which would have reduced participation in activities," state the study's authors.

The results of this study, according to its authors, suggest the need for longer-term, multicenter trials exploring the role of aromatherapy in the treatment of agitation in people with severe dementia, as an adjunct and/or alternative to psychotropic medication.

 - Source: Wolfson Research Centre, Newcastle General Hospital, Institute for Ageing and Health. Authors: Clive Ballard, M.D., John O'Brien, Katharina Reichelt and Elaine Perry, Ph.D. Originally published in the Journal of Clinical Psychiatry, July 2002, Vol. 63, No. 7, pp. 553-558.

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