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
Highlights
One of the most common symptoms observed in patients with dementia is agitation, and several non-pharmacological treatments have been used to control this symptom
The Cohen-Mansfield Agitation Inventory (CMAI) score was significantly higher in the aromaacupressure and aromatherapy groups compared with the control group in the pre- and post-tests; the average scores in the pre- and post-tests were highest in the aroma-acupressure group, followed by the aromatherapy group and the control group
Agitation was significantly more severe in the aromaacupressure and aromatherapy groups compared with the control group, and the CMAI score was significantly higher in the post-test and post-three-week assessments compared with the pre-test
Summary
One of the most common symptoms observed in patients with dementia is agitation, and several non-pharmacological treatments have been used to control this symptom. Yang et al BMC Complementary and Alternative Medicine (2015) 15:93 medical scientists from many backgrounds have used acupressure in their studies to alleviate symptoms such as agitation and sleeplessness [6,7], these studies did not measure the physiological parameters associated with agitation, which weakened their evidence in support of non-pharmacological treatment effects. The systematic review by Lee, Shin, and Ernst was unable to measure the effect of acupuncture treatment on Alzheimer’s disease (AD) because of the small sample size associated with randomized controlled trials (RCTs) [10]. Future clinical trials should follow standard procedures and include sufficient sample sizes
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