Dementia, one of the most common causes of disability globally, is characterized by memory loss, cognitive impairment, and behavioral and psychological symptoms. The Behavioral and Psychological symptoms of Dementia (BPSD) are widespread in this disease, affecting up to 90% of patients with dementia. The BPSD constellation of symptoms in dementia patients are agitation, anxiety, psychosis, depression, and apathy in addition to memory loss. Behavioral issues are frequently more distressing than memory changes.
As the condition progresses, people with dementia may become restless or aggressive. Agitation means a person is restless or anxious. They do not appear to be able to relax. Agitation causes pacing, sleeplessness, or anger and sometimes aggression, as a person might lash out both verbally and or physically, and might be a safety risk to themselves or others.
Treatment of agitation in dementia:
Off-label usage of harmful atypical antipsychotics is used to treat agitation in dementia, but pain control provides a significant reduction. Medications approved to treat dementia have poor efficacy against cognitive impairment or disturbing behaviors (behavioral and psychological symptoms or challenging behavior), which are often the most stressful condition for caregivers.
Aromatherapy and other complementary therapies are popular with patients, practitioners, and families because they have few side effects. As a result, there's a lot of curiosity about whether aromatherapy might help dementia patients with their agitated behaviors.
How does aromatherapy works in dementia?
Aromatherapy is a non-pharmacological treatment involving inhalation, ingestion, or topical use of plant essential oils for therapeutic purposes. Plant essential oils may help with agitation and BPSD treatment by activating the neuro-limbic system and up-regulating neurotransmitter synthesis to produce antidepressant, anxiolytic, or sedative effects [1]. Some essential oils have anticholinesterase activity in vitro [2], which is particularly useful in treating dementia [3].
Using an essential oil with analgesic qualities that is also non-toxic would be a useful choice for agitation management in dementia [4].
Lemon balm essential oil (Melissa officinalis)
Lemon balm is a well-known and thoroughly investigated oil for dementia. Lemon balm is the best used for patients having severe dementia with agitation. It is thought to assist dementia patients in relaxing. It also helps to slow the onset or progression of agitation in dementia [5]. It also aids in the treatment of insomnia and anxiety.
In one study, seventy-two persons with clinically significant agitation in severe dementia were randomly assigned to aromatherapy with lemon balm in National Health Service (UK) care facilities. Lemon balm was applied to patients' faces and arms twice a day. People who received essential balm oil had a considerably better quality of life indexes. The discovery that aromatherapy with essential balm oil is a safe and effective treatment for clinically significant agitation in patients with severe dementia, with additional improvements for key quality of life measures, calls for more research [6].
Bergamot essential oil
For someone with dementia, forgetfulness is one of the most annoying symptoms. For dementia patients, bergamot essential oil is the best oil to focus on. It's been shown to improve memory and reduce agitation, anxiety, depression, and stress. Bergamot essential oil, which has been shown to affect the endogenous, peripheral, and central opioid systems involved in painful states in inflammatory and neuropathic pain models[7], is also beneficial when inhaled. This oil can also be used to treat insomnia [8].
Lavender essential oil
Lavender is one of the most well-researched and widely utilized essential oils today. In dementia, anxiety, depression, and sleeplessness are treated with lavender. Many people and families find lavender a relaxing agent that helps the brain and body realize it's time to slumber when diffused in the room of someone who has insomnia at night[9]. In one study, lavender oil supplied as an aroma stream demonstrated modest benefit in treating agitated behavior in individuals with severe dementia[10].
How to use essential oil to reduce agitation in dementia?
Some ways to use essential oil are,
Take an Aroma bath by adding essential oil with a teaspoon of carrier oil, such as almond oil, jojoba oils, or a scentless bath gel. Just before entering, add the mixture to the warm bathwater.
Sprinkle essential oil spray on the bed linen or pillow cover before sleeping
Adding essential oil to the diffuser, the aroma will diffuse around the room.
Massage with essential oil at the back of the neck or forehead.
Bottom-line
Aromatherapy is becoming increasingly popular as a complementary and non-pharmacological treatment for dementia. It's worth thinking about, especially given the recent surge in investigation and attention on the link between essential oils and dementia.
Many health and wellness professionals feel that essential oils have numerous benefits for those living with dementia and that what we know so far is only the beginning. Several studies have shown that the technique can help people with various diseases.
Sources
Tsang, Hector WH, et al. "Neurophysiological and behavioural effects of lavender oil in rats with experimentally induced anxiety." Flavour and Fragrance Journal 28.3 (2013): 168-173.
Kiendrebeogo, Martin, et al. "Antiacetylcholinesterase and antioxidant activity of essential oils from six medicinal plants from Burkina Faso." Revista Brasileira de Farmacognosia 21.1 (2011): 63-69.
Hshieh, Tammy T., et al. "Cholinergic deficiency hypothesis in delirium: a synthesis of current evidence." The Journals of Gerontology Series A: Biological Sciences and Medical Sciences 63.7 (2008): 764-772.
Holmes, C., & Ballard, C. (2004). Aromatherapy in dementia. Advances in Psychiatric Treatment, 10(4), 296-300. doi:10.1192/apt.10.4.296
Watson, Karen, Deborah Hatcher, and Anthony Good. "A randomised controlled trial of Lavender (Lavandula Angustifolia) and Lemon Balm (Melissa Officinalis) essential oils for the treatment of agitated behaviour in older people with and without dementia." Complementary Therapies in Medicine 42 (2019): 366-373.
Ballard, Clive G., John T. O'Brien, and Elaine K. Perry. "Aromatherapy as a safe and effective treatment for the management of agitation in severe dementia: the results of a double-blind, placebo-controlled trial with Melissa." The Journal of clinical psychiatry 63.7 (2002): 1369.
Scuteri, D., Rombolà, L., Morrone, L. A., Bagetta, G., Sakurada, S., Sakurada, T., Tonin, P., & Corasaniti, M. T. (2019). Neuropharmacology of the Neuropsychiatric Symptoms of Dementia and Role of Pain: Essential Oil of Bergamot as a Novel Therapeutic Approach. International journal of molecular sciences, 20(13), 3327. https://doi.org/10.3390/ijms20133327
Scuteri, D., Sandrini, G., Tamburin, S., Corasaniti, M. T., Nicotera, P., Tonin, P., & Bagetta, G. (2021). Bergamot rehabilitation AgaINst agitation in dementia (BRAINAID): Study protocol for a randomized, double-blind, placebo-controlled trial to assess the efficacy of furocoumarin-free bergamot loaded in a nanotechnology-based delivery system of the essential oil in the treatment of agitation in elderly affected by severe dementia. Phytotherapy research : PTR, 35(10), 5333–5338. https://doi.org/10.1002/ptr.7223
Lin, Pamela Wan‐ki, et al. "Efficacy of aromatherapy (Lavandula angustifolia) as an intervention for agitated behaviours in Chinese older persons with dementia: a cross‐over randomized trial." International Journal of Geriatric Psychiatry: A journal of the psychiatry of late life and allied sciences 22.5 (2007): 405-410.
Holmes, Clive, et al. "Lavender oil as a treatment for agitated behaviour in severe dementia: a placebo controlled study." International journal of geriatric psychiatry 17.4 (2002): 305-308.