Background: Behavioural and Psychological Symptoms in Dementia (BPSD) are frequent and a major management problem, especially for patients with severe cognitive impairment. Preliminary reports have indicated positive effects of aromatherapy using select essential oils, but there are no adequately powered placebo controlled trials . We conducted a placebo controlled trial to determine the value of aromatherapy for agitation in people with severe dementia.
Method: Seventy two people with clinically significant agitation in the context of severe dementia, residing in NHS care facilities, were randomized to aromatherapy with Melissa (lemon balm) essential oil or placebo (sunflower oil). Changes in clinically significant agitation (Cohen-Mansfield Agitation Inventory -CMAI) and quality of life indices (% social withdrawal and % constructive activities measured with Dementia Care Mapping) were compared between the 2 groups over a 4 week period of treatment.
Results: Seventy-one patients completed the trial. No significant side effects were observed. Sixty percent of the active treatment group and 14% of the placebo treated group experienced a 30% reduction of CMAI score, with an overall improvement in agitation of 35% in patients receiving essential balm oil and 11% in those treated with placebo (Mann-Whitney U test –MWU - Z=4.1, p<0.0001). Quality of life indices also improved significantly more in people receiving essential balm oil (% social withdrawal MWU Z=2.6 p=0.005, %constructive activities MWU Z 3.5 p=0.001). Results from the other published placebo controlled studies will be presented and conclusions drawn regarding the overall evidence base.
Conclusion: Aromatherapy with essential balm oil is a safe and effective treatment for clinically significant agitation in people with severe dementia; with additional benefits for key quality of life parameters.
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