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Key points:

  • Lavender and lemon balm are currently the only aromatherapy treatments that have been empirically found to reduce BPSD.
  • Lavender and lemon balm have been found to reduce anxiety,agitation, sleep disturbance and improve mood, motivation and cognition in people with dementia.
  • Lavender and lemon balm are generally safe to administer, no significant side effects have been observed, however it may not be appropriate for people with lewy body dementia as studies have found increased agitation after treatment in this population.

What the research says:

  • Aromatherapy may be a useful treatment for the behavioural and psychological symptoms of dementia (BPSD), as currently, common treatment involving antipsychotics often only provides a modest therapeutic effect but induces a number of serious side effects including extra-pyramidal symptoms, cardiac related problems and falls (Fujii et al.2008).
  • Several plant species including lavender, chamomile, lemon balm and bergamot have been used in mental health for their perceived beneficial effects on conditions such as anxiety and depression. Lavender and lemon balm may be particularly useful for people with dementia due to their sedative and cognitive enhancing properties (Holmes & Ballard 2004).
  • There are psychological and pharmacological mechanisms involved with aromatherapy treatment. Psychologically, an individual’s perception of whether a certain odour is pleasant or not and whether they have positive or negative past associations with that odour influences whether the person with dementia will accept
  • the treatment. Pharmacologically, it is thought that aromatherapy is absorbed by the lungs or nasal mucosa, is transported to the brain via the bloodstream and then effects neurochemicals in the brain. This is important as it appears aromatherapy works even if the person with dementia has lost their sense of smell (Holmes & Ballard 2004).
  • Lavender (Lavendula angustifolia) has been used as a relaxant. It has a wide range of applications and has been shown to be effective for use in depression and anxiety in cancer patients (Fujii et al. 2008). Recent studies have provided evidence that lavender is effective for assisting with agitation and sleep disturbance in dementia and also helps people with dementia engage socially and participate in constructive activities (O’Connor et al. 2009; Holmes & Ballard 2004).
  • Lemon balm (Melissa officinalis) has similar properties, it has a soothing effect, anti-anxiety effect and sedative action. It has also been demonstrated to modulate mood and cognitive performance during acute administration (Akhondzadeh et al. 2003). Like lavender, lemon balm has also Last updated – March 2010 Mail: 27 Conyngham St GLENSIDE 5065 Phone: 1800 699 799 Fax: 08 8338 3390 Email: This email address is being protected from spambots. You need JavaScript enabled to view it. DBMAS Dementia Behaviour Management Advisory Services An Australian Government Initiative Helping Australians with dementia, and their carers been shown to be effective for agitation and sleep disturbance in dementia and assists people with dementia to engage in social and constructive activities (O’Connor et al. 2009; Holmes & Ballard 2004).
  • Unlike antipsychotic and other medications used to control BPSD, lavender and lemon balm do not appear to have any significant side effects (Akhondzadeh et al. 2003). Some research however has suggested that lavender/lemon balm may not be appropriate for people with Lewy body dementia as higher levels of agitation have been reported in some studies. Therefore, it is necessary to monitor the person with dementia when trialling aromatherapy, as with other medications (Holmes & Ballard 2004).
  • Lavender and lemon balm can be administered in different ways and still be effective, including via massage, air diffusion, burner, or dispersion on a pillow or handkerchief the person with dementia uses. There are no strict guidelines on dosage at present, as effects have been shown even at very low doses and by studies using differing dosages (Holmes & Ballard 2004). A professional aromatherapist could provide further guidance for dosage. It is necessary to ensure the lavender/lemon balm purchased is pure and has not been diluted with other ingredients.
  • Lavender and lemon balm are the substances researchers have concentrated on studying and found evidence for effectiveness for BPSD, including agitation, sleep disturbance, anxiety, cognition and motivation. Other substances may also have beneficial effects but have not been demonstrated to be effective at present (O’Connor et al. 2009).

Clinical findings of SA DBMAS:

  • If you are considering using aromatherapy topically for agitated behaviours, be mindful of how you approach the person with dementia as your approach may be perceived as threatening.

References:

khondzadeh, S, Noroozian, M, Mohammadi, M,Ohadinia, S, Jamshidi, AH & Khani, M 2003, ‘Melissa officinalis extract in the treatment of patients with mild to moderate Alzheimer’s disease: A double blind, randomised, placebo controlled trial, Journal of Neurology, Neurosurgery and Psychiatry, vol. 74, pp. 863-866.

Fujii, M, Hatakeyama, R, Fukuoka, Y, Yamamoto, T, Sasaki, R, Moriya, M, Kanno, M & Sasaki, H 2008, ‘Lavender aroma therapy for behavioural and psychological symptoms in dementia patients’, Geriatrics and Gerontology International, vol. 8, pp. 136-138.

Holmes, C & Ballard, C 2004, ‘Aromatherapy in dementia’, Advances in Psychiatric Treatment, vol. 10, pp. 296-300.

O’Connor, DW, Ames, D, Gardner, B & King, M 2009, ‘Psychosocial treatments of behaviour symptoms in dementia: a systematic review of reports meeting quality standards’, International Psychogeriatrics, vol. 21, no. 2, pp. 225-240.

 

Last update March 2010

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