Aroma therapy for dementia
Editorial Group: Cochrane Dementia and Cognitive Improvement Group
Published Online: 21 JAN 2009
Assessed as up-to-date: 7 JUL 2008
Copyright © 2009 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.
How to Cite
Holt FE, Birks TPH, Thorgrimsen LM, Spector AE, Wiles A, Orrell M. Aroma therapy for dementia. Cochrane Database of Systematic Reviews 2003, Issue 3. Art. No.: CD003150. DOI: 10.1002/14651858.CD003150.
- Publication Status: New search for studies and content updated (no change to conclusions)
- Published Online: 21 JAN 2009
In the realm of dementia treatment aroma therapy has received great interest. In a population of patients not served by many mainstream drugs with great efficacy, complementary therapies are among few other options. The perceived low side effect profile of aromatherapy is also attractive to practitioners and family of patients with reduced verbal communication. As such it has been tried for many symptoms of dementia; to reduce disturbed behaviour (e.g. Brooker 1997), promote sleep (e.g. Wolfe 1996), and stimulate motivational behaviour (e.g. MacMahon 1998). Amongst the most distressing facets of dementia are the 'Behavioural and psychological symptoms in dementia' (BPSD). This manifestation of dementia often stresses the relationships between the patient, carers and family. This area has received particular interest in the larger aroma therapy trials.
To assess the efficacy of aroma therapy as an intervention for people with dementia.
The Cochrane Dementia and Cognitive Improvement Group's Specialized Register was searched on 23 March 2008 to find all relevant trials using the terms: aroma therap*, complementary therap*, alternative therap* and essential oil*. The CDCIG Register contains records from major health care databases, grey literature sources and is updated regularly. Additionally, relevant journals were hand searched, and 'experts' in the field of complementary therapies and dementia contacted.
All relevant randomized controlled trials (RCTs) were considered. A minimum length of trial and requirements for a follow-up were not included, and participants in included studies had a diagnosis of dementia of any type and severity. The review considered all trials using fragrance from plants defined as aroma therapy as an intervention with people with dementia. Several outcomes were considered in this review, including cognitive function, quality of life, and relaxation.
Data collection and analysis
Titles and abstracts extracted by the searches were screened for their eligibility for potential inclusion in the review, which revealed four RCTs of aroma therapy for dementia that have been included in this review. None of these had published results in a form that we could use. However, individual patient data from one trial were obtained (Ballard 2002) and additional analyses performed. Analysis of co-variance was used for all outcomes, using a random effects model.
Four studies have been included in this review; but none had data in a form that could be used. The additional analyses conducted using individual patient data from Ballard 2002 revealed a statistically significant treatment effect in favour of the aroma therapy intervention on measures of agitation and neuropsychiatric symptoms.
Aroma therapy showed benefit for people with dementia in the only trial that contributed data to this review, but it is important to note there were several methodological difficulties with this study. More well designed large-scale RCTs are needed before clear conclusions can be drawn on the effectiveness of aroma therapy. Additionally, several issues need to be addressed, such as whether different aroma therapy interventions are comparable and the possibility that outcomes may vary for different types of dementia.
Plain language summary
The one small trial published is insufficient evidence for the efficacy of aroma therapy for dementia
Aroma therapy is the use of pure essential oils from fragrant plants (such as Peppermint, Sweet Marjoram, and Rose) to help relieve health problems and improve the quality of life in general. The healing properties of aroma therapy are claimed to include promotion of relaxation and sleep, relief of pain, and reduction of depressive symptoms. Hence, aroma therapy has been used to reduce disturbed behaviour, to promote sleep and to stimulate motivational behaviour of people with dementia. Of the four randomized controlled trials found only one had useable data. The analysis of this one small trial showed a significant effect in favour of aroma therapy on measures of agitation and neuropsychiatric symptoms. More large-scale randomized controlled trials are needed before firm conclusions can be reached about the effectiveness of aroma therapy.
在過去十年來，互補式療法(Complementary therapies)越來越常被使用，並且被應用在健康領域中，其中也包括了失智症。在各種互補式療法中，芳香療法被指出是最常使用在British National Health Service的方法，並且可能可以使用於有言語障礙以及對傳統療法效果有限的失智症患者。芳香療法已經被用在失智症患者身上以達到降低行為混亂(Brooker ，1997)、幫助睡眠(Wolfe，1996)和增加積極性(MacMahon，1998)等功效。
在2006年4月5日檢索了Cochrane Dementia and Cognitive Improvement Group's Specialized Register資料庫以取得所有相關試驗資料，檢索關鍵字為：「aroma therap*、complementary therap*、alternative therap*和essential oil*」，CDCIG Register資料庫中涵蓋有主要健康照護資料庫的資料，也會進行定期的更新，此外，也會檢索相關期刊，並詢問互補式療法和失智症領域的相關專家。
此翻譯計畫由臺灣國家衛生研究院(National Health Research Institutes, Taiwan)統籌。