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Intervention Review

Aroma therapy for dementia

  1. Francesca E Holt1,*,
  2. Theodore PH Birks1,
  3. Lene Marie Thorgrimsen2,
  4. Aimee E Spector3,
  5. Anne Wiles4,
  6. Martin Orrell5

Editorial Group: Cochrane Dementia and Cognitive Improvement Group

Published Online: 21 JUL 2003

Assessed as up-to-date: 7 JUL 2008

DOI: 10.1002/14651858.CD003150


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.

Author Information

  1. 1

    University of Cambridge, Physiology, Development and Neuroscience, Cambridge, UK

  2. 2

    Stonehaven, UK

  3. 3

    Chesham, Buckinghamshire, UK

  4. 4

    Oxford Brookes University, School of Health and Social Care, Oxford, UK

  5. 5

    University College London, Department of Mental Health Sciences, London, UK

*Francesca E Holt, Physiology, Development and Neuroscience, University of Cambridge, Cambridge, UK. fh265@cam.ac.uk.

Publication History

  1. Publication Status: New search for studies and content updated (no change to conclusions)
  2. Published Online: 21 JUL 2003

SEARCH

This is not the most recent version of the article. View current version (25 FEB 2014)

 

Abstract

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要

Background

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.

Objectives

To assess the efficacy of aroma therapy as an intervention for people with dementia.

Search methods

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.

Selection criteria

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.

Main results

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.

Authors' conclusions

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

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要

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.

 

摘要

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要

背景

使用芳香療法來治療失智症

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。

目標

本研究的主要目的在於評估使用芳香療法作為一種失智症患者介入性治療法的有效性。

搜尋策略

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。

選擇標準

所有相關的RCT試驗都有可能納入本研究中,短期的試驗和需要進行後續追蹤的試驗不會被納入研究中,被納入研究的患者包括患有任何嚴重程度或任何類型的失智症,所有試驗只要有使用由植物取得的香料進行芳香療法來作為失智症患者的介入性治療都會被考量納入研究中,本研究中會針對多個治療成果進行評估,包括了認知功能、生活品質和放鬆效果。

資料收集與分析

由檢索者擷取得到的試驗標題和摘要都會被篩選以確認是否符合納入本研究,其中有2個與芳香療法有關的RCT試驗是針對失智症的治療進行探討。這2篇已經發表的試驗結果我們都無法使用,然而其中一個試驗有取得個別患者數據可以進行其他的分析,針對所有的治療成果利用隨機效應模式進行共變分析。

主要結論

進一步的分析結果顯示使用芳香療法進行介入性治療對於躁動(agitation)與神經精神症狀(neuropsychiatric symptom)在統計學上有顯著的治療效果。

作者結論

本研究中只有一個試驗的數據可以說明芳香療法對於治療失智症是有幫助的,但是這個試驗中仍存在有數個方法學上的問題,因此在做出有關芳香療法對於失智症治療功效的結論之前,仍然需要進行更多具有良好試驗設計的大規模試驗,此外,有許多爭議仍待澄清,例如是否應該針對不同的芳香療法進行比較,或是不同類型的失智症對於芳香療法會產生不同的治療效果。

翻譯人

此翻譯計畫由臺灣國家衛生研究院(National Health Research Institutes, Taiwan)統籌。

總結

本研究中只有1個小型的公開試驗以不充分的證據來說明芳香療法對於治療失智症的功效,一般來說芳香療法是利用由植物(例如歐薄荷、甜馬鬱蘭和玫瑰)提取的純精油來舒緩與健康有關的症狀和提升生活品質,芳香療法的治療特性被認為是針對提升舒緩效果、幫助睡眠、舒緩疼痛和降低壓抑症狀等層面,因此,有人使用芳香療法來使得失智症患者降低行為混亂以提升睡眠品質和增加積極性行為,但本研究中發現了3個RCT試驗中只有1個試驗具有可用的數據,針對這個試驗進行的分析顯示,在檢測躁動與神經精神症狀時,進行芳香療法對於患者的症狀有明顯的改善,在針對芳香療法的功效做出結論前,仍然需要更多的大型隨機性對照實驗來提供相關證據。