Effect of aromatherapy on patients with Alzheimer's disease

ArticleinPsychogeriatrics 9(4):173-9 · December 2009with 1,236 Reads 
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Abstract
Recently, the importance of non-pharmacological therapies for dementia has come to the fore. In the present study, we examined the curative effects of aromatherapy in dementia in 28 elderly people, 17 of whom had Alzheimer's disease (AD). After a control period of 28 days, aromatherapy was performed over the following 28 days, with a wash out period of another 28 days. Aromatherapy consisted of the use of rosemary and lemon essential oils in the morning, and lavender and orange in the evening. To determine the effects of aromatherapy, patients were evaluated using the Japanese version of the Gottfries, Brane, Steen scale (GBSS-J), Functional Assessment Staging of Alzheimer's disease (FAST), a revised version of Hasegawa's Dementia Scale (HDS-R), and the Touch Panel-type Dementia Assessment Scale (TDAS) four times: before the control period, after the control period, after aromatherapy, and after the washout period. All patients showed significant improvement in personal orientation related to cognitive function on both the GBSS-J and TDAS after therapy. In particular, patients with AD showed significant improvement in total TDAS scores. Result of routine laboratory tests showed no significant changes, suggesting that there were no side-effects associated with the use of aromatherapy. Results from Zarit's score showed no significant changes, suggesting that caregivers had no effect on the improved patient scores seen in the other tests. In conclusion, we found aromatherapy an efficacious non-pharmacological therapy for dementia. Aromatherapy may have some potential for improving cognitive function, especially in AD patients.

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  • ... Their volatile nature may also enable their administration via vapor inhalation bypassing the digestive system with its accompanying possibility to modify molecular species of interest [13]. Apart from enzymatic assays (Ellman's method, TLC autobiography) on cholinesterases, there is a number of neuropharmacological studies conducted using essential oils in models of AD such as: Aβ (25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35) PC12 cells, primary hippocampal and cortical cells, scopolamine induced dementia in rats, Aβ(1-42) rat model, D-galactose and AlCl 3 induced dementia in mice, old triple transgenic Alzheimer's mice. Essential oils used in these studies were: Coriandrum sativum var. ...
    ... and Lavandula hybrida Rev. [17,18], Ocimum basilicum L. and Ocimum sanctum L. [19], Pimpinella peregrina L. [20], Rosmarinus officinalis L. [21], while pure components used were: β-asarone [22], 1,8cineole [23], linalool [18,24], limonene and perillyl alcohol [25], as well as thymoquinone [26]. Clinical studies on patients affected with dementia using different essential oils as treatment have also been reported [27][28][29][30]. ...
    ... Pulegone, linalool, citral and bornyl acetate showed promising activity against AChE crude protein extract from heads of adult waxmoth (Galleria melonella) with K i values of 0.032, 0.24, 0.33 and 0.51 mM, respectively [65]. Cell culture studies revealed that 1,8-cineole has a potential to mitigate the toxic effects induced by Aβ (25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35) on differentiated PC12 cells [23] while thymoquinone demonstrated inhibiton of spontaneous aggregation and neurotoxicity of Aβ in primary hippocampal and cortical neurons [26]. ...
    Article
    Full-text available
    Essential oils constituents are a diverse family of low molecular weight organic compounds with comprehensive biological activity. According to their chemical structure these active compounds can be divided into four major groups: terpenes, terpenoids, phenylpropenes, and "others". In addition, they may contain diverse functional groups according to which they can be classified as hydrocarbons (monoterpenes, sesquiterpenes, and aliphatic hydrocarbons); oxygenated compounds (monoterpene and sesquiterpene alcohols, aldehydes, ketones, esters, and other oxygenated compounds); and sulfur and/or nitrogen sulfur-containing compounds (thioesters, sulfides, isothiocyantes, nitriles, and others). Compounds that act as cholinesterase inhibitors still represent the only pharmacological treatment of Alzheimer´s disease. Numerous in vitro studies showed that some compounds, found in essential oils, have a promising cholinesterase inhibitory activity, such as α-pinene, δ-3-carene, 1,8-cineole, carvacrol, thymohydroquinone, α- and β-asarone, anethole, etc. This review summarizes the most relevant research published to date on essential oil constituents and their acetylcholinesterase/butyrylcholinesterase inhibitory potential as well as their structure related activity, synergistic and antagonistic effects.
  • ... 6 Non-pharmacological approaches have received much attention, and aromatherapy is considered a non-pharmacological therapy. In our previous study, 7 we reported a therapeutic improvement effect of aromas spread using a diffuser, which used rosemary camphor and lemon essential oil in the morning and true lavender and sweet orange essential oils in the evening, on cognitive function in patients with dementia. Moreover, other studies have reported that aromatherapy had effects on agitation and emotional functioning, 8 and improved the symptoms of sleep disturbance in patients with dementia. ...
    ... The aroma oil added to the bath salt was a 2:1 blend of true lavender and sweet orange, which had been confirmed to improve cognitive function in our previous research. 7 The intervention period was 24 weeks. Bathing was performed after 18:00 hours. ...
    ... However, because of difficulties in the recruitment process, the sample size was reduced to 43. In our previous study 7 that used the TDAS to examine the effect of aromatherapy on cognitive function, 17 patients with AD were studied. Therefore, we considered that the effect on cognitive function could be proven by including 20 patients in each group. ...
    Article
    Full-text available
    Background: Aromatherapy is a non-pharmacological therapy for the improvement of dementia symptoms. This study aimed to assess the effects of aroma oil as a bath salt on cognitive function, olfactory function and sleep quality. Methods: This was a randomised controlled trial. Overall, 49 patients were able to provide consent, and 35 were finally analysed (Alzheimer's disease: 10, mild cognitive impairment: 25). The patients were randomly assigned to use 0.1%, 0.5% or 1% aroma bath salt. During daily bathing, bath salt was added to the bath water, and the subjects remained in the bathroom for ≥10 min. The intervention period was 24 weeks, and the observation periods were 4 weeks before and after using the aroma bath salt. We performed the Touch Panel-type Dementia Assessment Scale (TDAS), the Odour Stick Identification Test for Japanese (OSIT-J) and the Japanese version of the Pittsburgh Sleep Quality Index (PSQI-J) five times during the before and after observation periods and after the 12-week intervention. Results: There were no significant changes in the TDAS, OSIT-J and PSQI-J scores before and after the intervention in all groups. Moreover, there were no significant differences in the TDAS, OSIT-J and PSQI-J scores between the groups before and after the intervention. In the correlation analysis of changes in the TDAS and other tests during the intervention period, significant associations between TDAS and sleep latency and sleep disturbances, which are sub-items of PSQI-J, were observed in the use of 0.1% aroma bath salt group. Conclusions: The use of aroma bath salt was not associated with improvement in cognitive function, olfactory function or sleep quality. However, sleep-related aspects were associated with changes in cognitive function before and after use of aroma bath salt, which suggested that there is a link between improvements in sleep and that in cognitive function.
  • ... [9][10][11] Clinical aromatherapy is the practice of using essential oils for specific quantifiable effects on the human mind, body, and spirit. [12][13][14]15 Lemon essential oil (Citrus limon) has been proven to increase cognitive functioning, memory, and attention levels in children 13 and patients with Alzheimer disease, 14 CTA among nursing students, 16 and improved mood. 17 The American Holistic Nurses Association advocates and is committed to assessing clients (students) holistically and identifying a broader scope of factors that are potential contributors to increased stress. ...
    ... Citrus limon contains high levels of a natural substance called D-limonene, which has shown to have benefits for cognitive processing, memory, and attention in adults as well as in children. 13,14 D-limonene is a nonstimulant, which is important for a calming environment during an examination. The 100% C. limon that was used for this study was purchased from Aura Cacia and produced in Italy. ...
    Article
    Full-text available
    Nursing programs are stressful learning environments, and students are expected to maintain high academic performance to successfully graduate. Cognitive test anxiety has been minimally studied among nursing students, including how to successfully manage. The Cognitive Test Anxiety Scale (CTAS) was administered to 31 students before and after a high-stakes nursing examination. The intervention was inhaled lemon essential oil delivered via a personal nasal device. Neither the control nor the experimental group demonstrated a statistically significant change in the CTAS score from pretest to posttest (P = .19). More quantitative studies are warranted with undergraduate nursing students, the CTAS, and aromatherapy to reduce the burden of cognitive test anxiety.
  • ... While antipsychotic drugs may cause fatal side effects including pneumonia, stroke, and myocardial infarction, 18,45 most studies where aromatherapy was applied have reported no side effects. 20,21,46 Caregiver distress according to the NPI was lower in the intervention group than in the control group at 2 and 4 weeks. Caregiver burden according to the ZBI did not change in the intervention group during the study period, but it was significantly increased in the control group at 4 weeks when analyzing within groups. ...
    ... We found no previous studies that addressed the effects on caregiver burden when aromatherapy was given to dementia patients staying at home. However, Jimbo et al. 46 analyzed the effects of aromatherapy on patients' cognitive function and nurses' caregiver burden. In their study, aromatherapy was delivered via direct inhalation to patients with dementia residing in nursing homes. ...
    Article
    Full-text available
    Introduction: In dementia, psychiatric and behavioral symptoms develop over time. One of the most frequently observed behavioral symptoms is agitation. The caregivers of dementia patients with agitation have an increased burden. Therefore, studies are needed to examine the effect of aromatherapy on agitation in dementia. The aim of this study was to examine the effects of aromatherapy on agitation in patients with moderate to severe dementia and caregiver burden. Method: The study was carried out in patients with dementia and their caregivers at two university hospitals in Turkey. The study sample comprised a randomly selected aromatherapy (n=14) and control group (n=14). Patients in the study were stratified by dementia phase and taking antipsychotic medication. The intervention group was given aromatherapy via hand massage and inhalation for 4 weeks in their home. The control group received no intervention during the study. The data were collected using Neuropsychiatric Inventory (NPI), Cohen–Mansfield Agitation Inventory (CMAI) and Zarit Burden Interview (ZBI). Results: The NPI scores of intervention-group significantly decreased at weeks 2 and 4 compared with control patients (p<0.05). In addition, CMAI and ZBI scores were significantly lower in the intervention group compared with the control group at week 4 (p<0.05). Conclusion: After aromatherapy, agitation, neuropsychiatric symptoms and caregiver burden in the intervention group had significantly decreased compared with the control group.
  • ... Aromatherapy is widely used for variety of purposes [1][2][3][4]. Generally, essential oils extracted from plants or fruits are used for aromatherapy as the fundamental fragrance component. ...
    ... Generally, essential oils extracted from plants or fruits are used for aromatherapy as the fundamental fragrance component. Recent studies revealed that aromatherapy using essential oils may provide clinical benefits and could be used as an alternative medical treatment for hypertension [1,2,5,6], hypotension [1,3], cognitive dysfunction [4], and physical and psychological stress and exhaustion [2,[7][8][9][10][11]. For example, Fernandez et al. [3] reported that the anti-hypotensive effect of exposure to 1 mL of rosemary essential oil every 8 h was maintained in hypotensive patients when compared to the pretreatment period. ...
    Article
    Full-text available
    Fragrance inhalation of essential oils is widely used in aromatherapy, and it is known to affect blood pressure (BP) and heart rate (HR) via autonomic control of circulation. In this study, we aimed to test the hypothesis that the changes in hemodynamics with fragrance inhalation were observed along with changes in muscle sympathetic nerve activity (MSNA). In study 1, thirteen healthy men were exposed to fragrance stimulation of grapefruit essential oil for 10 min, and BP, HR, and MSNA were continuously measured. In study 2, another nine healthy men were exposed to the same fragrance stimulation; responses in BP and HR were continuously measured, and plasma noradrenaline and cortisol concentrations were determined. We found that diastolic BP increased significantly during fragrance inhalation, while the other variables remained unchanged in both studies. Although MSNA burst frequency, burst incidence, and total activity remained unchanged during fragrance inhalation, we found a significant linear correlation between changes in diastolic BP in the last 5 min of fragrance inhalation and changes in MSNA burst frequency. The plasma cortisol concentration decreased significantly at 10 min of fragrance inhalation, though the noradrenaline concentration remained unchanged. These results suggest, for the first time, that changes in BP with fragrance inhalation of essential oil are associated with changes in MSNA even with decreased stress hormone.
  • ... Alzheimer's disease is the most common cause of dementia and is mostly figured at the age of 65. The effects of aromatherapy were studied on elderly people suffering from dementia, with the majority being diagnosed with Alzheimer's disease were found to have a success rate of recovery as compared to the alternative therapeutic tool with no side effects [38]. Alzheimer disease is one of the most prevalent neurodegenerative disorders, characterized by, scarcity in cholinergic neurotransmission, cognitive dysfunctions, behavioral turbulence, gradual memory loss oxidative stress, accumulation of amyloid plaques and neurofibrillary tangles in the brain areas. ...
    ... It is desirable to use natural compounds with a decreased risk of side effects compared to synthetic components of drugs. Considering the current methods of alternative medicine aromatherapy is highly popular and reasonably trustworthy among the professionals [38]. The topicality of studying the effects of essential oils is induced by a number of advantageous points. ...
    Article
    Full-text available
    Aromatherapy or Essential oil therapy is attributed towards the field of conventional, alternative or complementary therapies which requires essential oils and other aromatic plant compounds. Essential oils (EOs) belong to the class of highly volatile compounds which, due to their higher concentrated natural constituents acquire unique properties and hence, are being used for its wide range of therapeutic health benefits. Their benefits widely range from being a potential antimicrobial, antidepressant, antiviral and antiseptic agents to the elevator of many CNS related behaviours like - anxiety, stress, wisdom, memory, attention, relaxation, sedation, and sleep. Furthermore, the effects on mood, pain, and perception too are being influenced by the use of essential oils. It also helps in the treatment of epilepsy, stress, dementia by giving calming and soothing effects to the nerve cells and is also effective against dementia and on the treatment of Alzheimer’s disease.
  • ...  Aromatherapy is a traditional treatment in which the aromatic molecule from essential oils passes through the nasal cavity and adheres to the olfactory epithelium, causing nerve stimulation directly to the hippocampus and limbic amygdaloidal body. This consequently triggers stimuli that control the autonomic nervous system and internal secretory control by changing a number of vital reactions [39] . The inhalation of aromatic compounds present in essential oils is the reason for the name "aromatherapy" and this therapy may have sedating or stimulating effects on the individual [40] . ...
    Article
    Full-text available
    In recent years there has been an increasing interest in the replacement of synthetic compounds by natural products due to environmental, health and safety concerns. Among natural products, essential oils of aromatic plants are gaining much interest as food additives due to their relatively low or negligible toxicity, high volatility and biodegradability. Cymbopogon martini (Gramineae) is very important medicinal and aromatic plant and is rich in essential oils. Essential oils derived from Palmarosa have been reported to exhibit exceptionally good antimicrobial, antifungal, antiviral, antihelmintic, antioxidant and cytotoxic properties. Thus the main aim of present review article is to uncover the various therapeutic activities of Palmarosa essential oil and chemical compounds responsible for such properties.
  • ... พั นล้ านบาท (Sinsrichai, 2002) (Perry & Perry, 2006;Jimbo et al., 2009;Smith et al., 2011;Lai et al., 2011) (Gupta et al., 2010;Martín et al., 2010) (Rohmer et al., 1996;Lange et al., 2000) ภาพที ่ 2 วิ ถี สั งเคราะห์ น ้ามั นหอมระเหยในพื ช (Zuzarte & Salgueiro, 2015) ทั Natural Product Communications,9(4), 587-594. ...
    Article
    Full-text available
    Essential oils are plant natural products with aroma and volatility which can be extracted from parts of plants such as flower, bark, stem, leaf, root and fruit by distillation or other methods. From the past till present, essential oils have been used as part of perfumes, body and mind remedy, skin treatment, flavors or aromas for foods and beverages. Aromatherapy or a therapy with aroma from essential oils has been an alternative remedy for ailments in addition to conventional treatments with modern medicines and it has increasingly gained popularity nowadays since scientific evidence have suggested that essential oils showed bioactivities. Absorption through membrane via inhalation, topical application or ingestion helps essential oils pass into blood circulation to act upon the affected sites for alleviating pain, depression, constipation, migraine, insomnia, muscular pain, blocked respiratory system, skin ailments, or even cancers. This review will entail information on biosynthesis of essential oils in plants, extraction methods, mechanisms of essential oils, their applications in aromatherapy and also some safety concerns.
  • ... Several studies have demonstrated the curative effects of aromatherapy (therapeutic use of essential oils) in elderly people with dementia and Alzheimer's disease (AD). Aromatherapy has shown some potential for improving cognitive function, especially in AD patients [29] [30] [31]. ...
    Preprint
    BACKGROUND All over the world the increasing prevalence of age-related disorders such as Alzheimer’s disease (AD) and frailty and its impact on functional decline is challenging the sustainability of health care systems. In the field of AD and related disorders, Information and Communication technologies (ICT) showed promising results in improving clinical assessment and implementing interventions to delay functional decline and decrease the burden of behavioral symptoms. OBJECTIVE The SafEE (Safe Easy Environment) project, is a collaborative French-Taiwanese project aiming to develop: 1/ an ICT-based behavior analysis platform able to automatically detect, recognize and assess daytime and nighttime behavioral patterns, and 2/ adapted tailored non pharmacological interventions. Partners of the projects include clinicians, research engineers and industrials. METHODS This study was designed as a randomized controlled trial. We recruited 3 patients with cognitive frailty syndrome [≥ 60 years, MMSE ≥ 26, CDR ≤ 0.5] randomized either to the intervention group (ICT-based therapeutic solutions, N=1) or to the control group (care as usual, N=2). The 6-month intervention included detection of daytime and nighttime behaviors based on 2D and 3D video cameras (for both groups), and tailored therapeutic solutions based on serious-games, aromatherapy and music therapy for the intervention group. The primary outcome is the acceptability of the solutions measured by the frequency of use and self-reports. The secondary outcome is the solution efficacy, measured by the results on neuropsychological tests. RESULTS This project made it possible to develop a communicating platform between the automatic recognition of activity and the non-pharmacological solutions developed. This platform is thus able to 1) provide healthcare professionals with continuous feedback on immediate and long-term risk events; 2) Automatically combine an online assessment with non-pharmacological interventions that can act on the detected disorders; 3) obtain relevant information in the context of an early diagnosis at home of frail people at risk of developing Alzheimer's disease. CONCLUSIONS Building a global system aiming to detect and prevent loss of autonomy in frail people is a rather complicated task, involving numerous ICT solutions which are not always easy to use in everyday life. The innovation of the project lies in a new methodological approach to deal with care of elderly people, based on an innovative use of ICT based on the association of assessment and intervention for specific cognitive and behavioral patterns. The results of this trial may have important implications for future interventions, and provide relevant information for the general transferability of this platform as part of the AD prevention. CLINICALTRIAL ClinicalTrials.gov, NCT02288221. First received: August 19, 2014. Last updated: November 7, 2014. Last verified: June 2014.
  • ... Jimbo and co-workers [38] studied the healing effects of rosemary, lemon, lavender and orange essential oils in 28 elderly patients with dementia, 17 of whom had AD. Small amounts of each essential oil were placed in a diffuser within the vicinity of each patient. ...
  • ... Nevertheless, the use of smells can be beneficial for people with Alzheimer's disease. For example, a small scale aromatherapy study indicated towards improvement of cognitive functioning and some improvement in conceptual understanding [18]. More directly related to HCI research, Gowans et al. ...
    Chapter
    Many nursing homes for dementia patients struggle with residents that wander towards the exit with the intention of leaving. Several types of interventions have been used to deal with this issue. Unfortunately, many of them are quite forceful, or are unsuitable for the specific context of certain nursing homes. In this paper, we investigate the possibility to using a more playful persuasive intervention. The design itself is in the form of a lost puppy, equipped with several actuators and sensors, that has to be brought ‘home’, in order to steer residents unknowingly away from the exit. Our first pilot indicated that residents noticed the puppy and showed interest in the device, and might be distracted from the exit. However, the puppy in its current form did not yet lead the residents away from the exit. Based on our contextual analyses, related work, and received feedback, we share our design insights which could be helpful for creating playful interventions for people with dementia.
  • ... 12 Recently, complementary alternative medicine, which, in addition to using medications, also makes use of various "nonpharmacological" approaches, has become an attractive alternative in the treatment of senile dementia. 13 Essential volatile oils from plant or animal sources were used in preventing and treating many clinical problems, and this is known as aromatherapy. 14 In psychiatry, aromatherapy was used for improving emotional changes in different neurodegenerative diseases specifically in treating dementia in both experimental animal model and human. ...
    Article
    Objective: This study aimed to evaluate the effect induced by musk on Alzheimer's disease-such as neurodegenerative changes in mice exposed to chronic unpredictable mild stress (CUMS). Material and methods: Forty male Swiss albino mice were divided into 4 groups (n = 10); control, CUMS, CUMS + fluoxetine, CUMS + musk. At the end of the experiment, behavior of the mice was assessed. Serum corticosterone level, hippocampal protein level of the glucocorticoid receptors, and brain-derived neurotropic factor were also assessed. Hippocampus was histopathologically examined. Results: Musk improved depressive status induced after exposure to CUMS as evidenced by the forced swimming and open field tests and improved the short-term memory as evidenced by the elevated plus maze test. Musk reduced both corticosterone levels and the hippocampal neurodegenerative changes observed after exposure to CUMS. These improvements were comparable to those induced by fluoxetine. Conclusion: Musk alleviated the memory impairment and neurodegenerative changes induced after exposure to the chronic stress.
  • ... With regard to this observation, it is hypothesized that the olfactory excitation provided by the aromatherapy can help in stimulating the neuropoiesis in the olfactory bulb. As olfactory region tends to be directly in communication with the hippocampus and limbic system, it is believed that the neuronal regeneration reaches these regions and initiates neuropoeisis that ultimately improves the cognition and prevents further deterioration and memory loss (Jimbo, et al, 2009). ...
    Article
    Full-text available
    Aromatherapy is an ancient scent treatment that has gained a lot of attention in the contemporary research for its various benefits. The role of olfactory stimulation leading to neuropoeisis has been a major consideration for treating neurodegenerative disorders like dementia, Alzheimer's and Parkinson's as well as psychiatric symptoms like mood disturbances, anxiety and sleep problems. The literature review has concentrated on the significance of the olfaction in the mammalian physiology and enlightened the hypothesis with noteworthy evidences to support the idea that with more research and clinical trials aromatherapy can attest to be a major breakthrough in treating Alzheimer's disease and reversing neurodegeneration.
  • ... The activity of each class depends on the recipient organism (Kennedy et al. 2010). The alkaloid compound, galantamine, isolated from Galanthus woronowii (Heinrich and Lee Teoh 2004), the alkaloids, Huperzine A and B, isolated from the Chinese club moss, Huperzia serrata (Wang et al. 2006), the terpenoid, α-solanine, isolated from solanaceous species (Benilova et al. 2006) and the hydrocarbon cyclic terpene, d-limonene, isolated from Citrus limon (Jimbo et al. 2009) have been reported to be useful for the treatment of Alzheimer's disease associated dementia. ...
    Article
    Full-text available
    The bioactive compound, bacoside A, has immense importance for the treatment of memory disorders and Alzheimer’s disease. Due to the growing commercial interest in the herb, Bacopa monnieri, it has been listed as highly endangered species. The present study was aimed at enhancing the production of bacoside A using an alternative technology of plant cell suspension culture. Initial experiments of docking simulations using bacoside A showed good inhibition of acetyl cholinesterase (binding energy value of − 20 kcal/mol), when comparison was made with other phytocompounds and the synthetic drug for Alzheimer’s disease. In vitro experiments established that B. monnieri cell suspension culture can be developed in Murashige and Skoog medium containing containing 0.1 mg/L benzylaminopurine and 0.5 mg/L naphthalene acetic acid. Plackett–Burman studies predicted that the most effective factors for maximum biomass production were inoculum size (t-value of 4.87), sucrose concentration (t-value of 0.25) and KH2PO4 concentration (t-value of 0.007). The nitrate to ammonium ratio (t-value of − 0.42) did not have significant effect on the cell suspension biomass. The optimum concentration of the crucial variables obtained from a central composite design were—inoculum size of 2 g/L, sucrose concentration of 30 g/L and KH2PO4 concentration of 1.24 mM in one-sixth strength MS medium. The best model for optimum production of biomass and bacoside A was experimentally verified and the correlation between the predicted and actual values was found to be 99% for biomass and 94% for bacoside A production. The experimental results have been discussed in the present work.
  • ... Use of lavender essential oil as a part of an aromatherapy in 28 elderly people (17 of whom had AD), showed significant improvement in personal orientation related to cognitive function after therapy. So, this aromatherapy was efficacious therapy for dementia (Jimbo et al., 2009). In a cross-over experiment, lavender or lemon odor improved performance four weeks later in both free recall and recognition of a word list. ...
    Article
    Full-text available
    Background: A few factors such as age, stress, and emotions may lead to impaired learning, memory loss, amnesia, and dementia or threats like schizophrenia and Alzheimer's disease (AD). Iranian traditional medicine (ITM) recommends some herbs and herbal preparations for the treatment or prevention of CNS problems. Methods: In this study, scientific evidence related to the effectiveness of ITM herbal medicine on memory, learning and AD is reviewed. The scientific evidence of plant efficacy was searched in electronic databases including PubMed, Scopus, SID, Science Direct, and Google Scholar by keywords such as memory, Alzheimer, amnesia, learning and scientific plant names from 1969 to 2014. Results: The findings of this study confirmed the effectiveness of certain ITM medicinal plants on enhancing memory and learning or in the treatment/prevention of amnesia and AD. Some ITM plants like Melissa officinalis, Crocus sativus and Nigella sativa showed improving effects on memory and the treatment of AD in clinical trials. In some cases, active principles responsible for the efficacy of these plants on memory were also determined. Discussion: Most of the studies on ITM plants were designed in animal models and a few herbs were evaluated in clinical trials on AD. Furthermore, there are insufficient or no investigations on certain herbal medicines used in ITM to confirm their effectiveness on memory and learning. Therefore, further experimental and clinical studies are necessary to evaluate the effectiveness of these plants on memory and AD as well as determining their active components.
  • ... En este sentido, debido a los efectos adversos de los antipsicóticos prescritos en la demencia, se buscan nuevas formas de tratamiento para poder contrarrestar los síntomas conductuales y psicológicos, sin embargo, hasta el 2008, un metaanálisis encontró que la evidencia era aún escasa para corroborar la eficacia de las intervenciones con AE en estas dolencias (35). Sin embargo, en otros estudios donde se evaluaron mezclas de AE de limón y romero por las mañanas y lavanda y Citrus sinensis (naranja) por las noches, los pacientes con demencia por enfermedad de Alzheimer leve o moderada mostraron mejora significativa en la orientación, percepción, abstracción, y comprensión (36). Por otro lado, un estudio encontró que los AE podrían afectar las funciones cognitivas, encontrando que AE de lavanda afectaba negativamente la memoria y la atención de los participantes (37). ...
    Article
    Full-text available
    La aromaterapia usa como principales agentes terapéuticos los aceites esenciales. En el presente trabajo se realizó una breve revisión sobre la aromaterapia usada en la salud mental, donde se describe evidencia a favor y en contra del uso de la aromaterapia en el estrés, ansiedad, depresión, trastornos del sueño, trastornos cognitivos y otros trastornos; así como también se presentan datos relacionados a su seguridad, efectos adversos, contraindicaciones y mecanismos de acción; concluyendo que la aromaterapia puede ser considerada como una opción que puede ser utilizada como complemento a los tratamientos destinados al restablecimiento de la salud mental y trastornos asociados. Palabras clave: aromaterapia, salud mental, aceites esenciales.
  • ... Recent clinical studies show that essential oils, inhaled or orally administered, enter the blood stream and exert psychological effects, thus complementing pharmacodynamic mediation. For instance, inhalation, or oral administration of essential oils improves the quality of sleep[12,13], attenuates symptoms of dementia[14,15], negative affect[16], anxiety[11,17], nicotine craving[18], post-traumatic stress disorder[19]and Alzheimer's disease[20]. Preclinical pharmacological studies of essential oils and/or their isolated chemical constituents are becoming more common[21][22][23][24]. ...
    Article
    Full-text available
    Depression is a disease that has affected a high proportion of the world’s population and people of different ages, incapacitating them from good performance at work and in social relationships, and causing emotional disorders to millions of families. Therefore, the search for new therapeutic agents is considered a priority for the discovery of more effective forms of treatment. In this review, studies of essential oils and their constituents in experimental models related to depression are discussed. The mechanisms of action of the oils and the presence of psychoactive constituents in their chemical compositions are discussed. The data in the review show the therapeutic potential of essential oils and their chemical constituents for use in depressive disorders. Advanced studies using humans are needed to confirm the antidepressant properties described in animals.
  • ... In latest human trials, aromatherapy is an efficacious non-pharmacological therapy for dementia and may have some potential for improving cognitive function, especially in Alzheimer's disease patients, due to its free radical scavenging activity. [30,31] improving the feeling of well being, supporting mental alertness and suppressing aggression and anxiety. [33] Lavender oil shows its antibacterial and antifungal properties against many species of bacteria, especially when antibiotics fail to work, but the exact mechanisms are yet to be established. ...
  • ... The results of the study showed a positive effect of the aromatherapy on cognitive indices of the participants of the study. 5 The studies were conducted to assess the effect of 1,8-cineole containing in the rosemary essential oil on the cognitive performance and mood of a person. The study involved 20 healthy volunteers. ...
    Article
    Full-text available
    The research results of the effect of essential oils on the human short-term image and numerical memory have been described. The study involved 79 secondary school students (34 boys and 45 girls) aged 13 to 17 years, residents of the Ukrainian metropolis. Participants were divided into three groups: the control group, “Lavender” group, in which the lavender essential oil was sprayed, and “Rosemary” group, in which the rosemary essential oil was sprayed. The statistically significant differences in productivity of the short-term memory of the participants of different groups have been found. Therefore, the essential oils of rosemary and lavender have significantly increased the image memory compared to the control. Inhalation of the rosemary essential oil increased the memorization of numbers, and inhalation of the lavender essential oil weakened this process.
  • ... Treatment and effective prevention methods of Alzheimer's disease has not yet been discovered. Thus, in health-care settings such as nursing homes and day care centers, "nonpharmacologic" approaches are being introduced to help maintain the mental condition of elderly people with dementia [2]. Nonpharmacologic therapies include music, reminiscence, art, and reality orientation therapies, and have been shown to improve quality of life (QOL) and prevent disability among elderly people. ...
    Article
    Objective: The purpose of this study was to examine the effects of an intervention of a horticultural activities training program for the staff in the nursing home. Methods: The participants (n=13) were the staff in the nursing home (nurses, care workers, occupational therapists). They were divided into six to seven people per group (a total of 2 groups). The training was carried out 90 min once a month. The training was carried out a practice and lecture. It was carried out a total of four times for each group. We conducted a questionnaire on training content after the training. Results: From the answers of the participants to the training content, participants showed almost satisfaction to the training content. Our results demonstrate the benefits of participation in a horticultural activities training program improved after the intervention. With regard to comments, Training content would lead to acquisition of knowledge about horticultural activities, and an increased motivation to care for dementia using of horticultural activities. Conclusions: We suggest that horticultural activities training program would lead to interest in horticultural activities for dementia to staffs, and increased motivation for the use of horticultural activities to staffs. However, the number of participants in this study was small. Therefore, further, involving a greater number of participants are necessary to confirm the effects of horticultural activities training program for the staff in the nursing home.
  • ... When the lavender massage and the placebo massage results were compared, it shows that aromatherapy or lavender massage was more effective in reducing dysmenorrhea (Apay, Arslan, Akpinar, & Celebioglu, 2012). Jimbo et al. (2009) studied the effect of aromatherapy on Alzheimer"s patients in Japan. Dementia is one of the common symptoms suffered by Alzheimer"s patients. ...
  • ... Other studies reported reduced risks of developing dementia with consumption of light-to-moderate alcohol [6], green tea [7] and Mediterranean diet [8]. Further studies found that exercise [9], intellectual activities [10], and aromatherapy [11], which activate the brain, were useful in decreasing dementia and improving cognitive function; in other words, effects of adjusting the environment in the brain or the continuous transmission of sensory signals to the brain help to prevent cognitive decline. However, evidence on the effects of non-pharmacological interventions on the cognitive symptoms of patients with moderate or severe dementia is currently limited. ...
    Article
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    Background/objectives This study assessed the effect of continuous ingestion of monosodium l-glutamate (MSG) on cognitive function and dietary score in dementia patients. Subjects/methods This was a single-blind, placebo-controlled trial involving 159 subjects with dementia residing in a hospital or nursing home. We assigned the subjects to a group that ingested MSG thrice daily (0.9 g/dose) (MSG group; n = 79) or a group that ingested NaCl thrice daily (0.26 g/dose) (Control group; n = 80). This study consisted of a 12-week intake period, followed by a 4-week follow-up period without the ingestion of MSG or NaCl. We performed physical examination, cognitive symptom tests (the Touch Panel-type Dementia Assessment Scale (TDAS) and Gottfries–Bråne–Steen Scale (GBSS)), palatability and behaviour questionnaires, and blood tests before and after the intervention and after the follow-up period. Results There were no significant differences in the TDAS and GBSS total scores between the groups before and after the intervention. However, regarding the TDAS sub-items, “the accuracy of the order of a process” did not deteriorate in the MSG group compared with that observed in the Control group (p < 0.05). At the follow-up assessment, the TDAS total scores in the MSG group showed significant improvement compared with those reported in the Control group (p < 0.05). Furthermore, there was a correlation of changes from pre-intervention to post-intervention between the TDAS and enjoyment of the meal (r = −0.299, p = 0.049). Conclusions Our results suggest that continued ingestion of MSG has an effect on cognitive function. Furthermore, the patients with improved questionnaires about palatability survey showed greater improvement in cognitive function.
  • ... The interviewee also reported using oils "for stimulation" with PWD, which falls under the definition of aromatherapy (Scales, Zimmerman, & Miller, 2018). Aromatherapy has some research that indicates it may decrease agitation in people with severe dementia (Holmes et al., 2002) and increase orientation for people with AD (Jimbo, Kimura, Taniguchi, Inoue, & Urakami, 2009). ...
    Article
    The intent of this research was to investigate how speech-language pathologists (SLPs) are assessing and treating people with dementia (PWD). To examine this the researcher first completed a literature review to determine prominent evaluation and treatment procedures for dementia. Then the researcher set out to identify whether there was a gap between the external evidence found in the literature and the practice patterns of SLPs, and subsequently attempt to delineate potential reasons for the differences. Using a mixed-method design, the researcher conducted 10 phone interviews and 114 SLPs participated in an online survey. The researcher engaged in grounded theory coding procedures for the interviews. Survey data were analyzed based on demographic groups (e.g., rural versus urban) using non-parametric procedures. In general, the results suggested that SLPs are completing some of the assessment and treatment procedures identified in the literature. In regard to assessment, there was a departure from the literature in terms of the need to screen for vision/hearing and depression and engaging differential diagnosis to inform the evaluation. Both qualitative and quantitative results yielded a discrepancy in the use of vocabulary across participants. In fact, some SLPs reported engaging in procedures without having a name for them. SLPs with more years of experience and more dementia-related CEUs had higher confidence in completing several dementia-related procedures than those with fewer years/CEUs. Participants with fewer dementia-CEUs and a smaller caseload of PWD were less familiar with treatment approaches identified in the extant literature than those with more CEUs/higher caseloads. Participants with fewer dementia-CEUs reported using external memory aids less frequently than those with more CEUs; and, SLPs with fewer years of experience used errorless learning less frequently than those with more years of experience. Barriers that emerged that identify sources of gaps between the literature and clinical practice (i.e., implementation of EBP) included: lack of time, lack of carryover by caregivers, insurance barriers, lack of applicability of research, limited evidence, and lack of materials/resources. Advisor: Kristy Weissling
  • ... improved personal orientation on the tested standards. This study confirmed that rosemary extract improved cognitive functions (Jimbo, Kimura, Taniguchi, Inoue, & Urakami, 2009). Also, rosemary oil sachets lowered test anxiety measure, personal statements, and pulse rates (McCaffrey et al., 2009). ...
    Article
    Full-text available
    Rosmarinus species are aromatic plants that mainly grow in the Mediterranean region. They are widely used in folk medicine, food, and flavor industries and represent a valuable source of biologically active compounds (e.g., terpenoids, flavonoids, and phenolic acids). The extraction of rosemary essential oil is being done using three main methods: carbon dioxide supercritical extraction, steam distillation, and hydrodistillation. Furthermore, interesting antioxidant, antibacterial, antifungal, antileishmanial, anthelmintic, anticancer, anti‐inflammatory, antidepressant, and antiamnesic effects have also been broadly recognized for rosemary plant extracts. Thus the present review summarized data on economically important Rosmarinus officinalis species, including isolation, extraction techniques, chemical composition, pharmaceutical, and food applications. Rosmarinus species are aromatic plants that mainly grow in the Mediterranean region. They are widely used in folk medicine, food, and flavor industries and represent a valuable source of biologically active compounds (e.g., terpenoids, flavonoids, and phenolic acids). The extraction of rosemary essential oil is being done using three main methods: carbon dioxide supercritical extraction, steam distillation, and hydrodistillation.
  • ... This calming effect is attributed to LEO's inhibitory effect on the autonomous nervous system (ANS) [34]. LEO also has a role in improving cognition, abstract ideas formation, and conceptual understanding of AD patients [35]. Another study demonstrated LEO's ability to improve memory and cognition for AD rats [36]. ...
    Article
    Full-text available
    Lavandula dentata L. and Origanum syriacum L. essential oils have numerous health benefits and properties, such as possessing common components with a variant degree of depressive actions in the central nervous system. We investigated the depressive property of these oils on AMPA receptors, which are responsible for most of the fast-excitatory neurotransmission in the CNS and play a critical role in synaptic plasticity. Since excessive activation of AMPARs has been linked to neurotoxicity leading to various pathologies, we hypothesize that these oils have a neuroprotective role by acting directly on the kinetics of AMPARs. Using Gas Chromatography-Mass Spectrometry (GC/MS) and patch-clamp electrophysiology, the essential oils of L. dentata flowers and O. syriacum leaves were characterized and the whole cell currents were measured with and without the administration of the oils onto HEK293 cells. The current study results showed that the biophysical properties of AMPA receptor subunits showed a decrease in desensitization rate of GluA1 and GluA2 homomers, using O. syriacum , while administering L. dentata oil decreased the desensitization rate of GluA1 and GluA2 homomers, as well as GluA1/2 heteromers. As for the deactivation rate, both oils slowed the deactivation kinetics of all AMPA receptor subunits. Intriguingly, between the two oils, the effect of desensitization and deactivation was of a greater significance for L. dentata oil than O. syriacum . Our data suggest that the two oils contain components that are essential to identify, as those active components underlie the oils’ neuronal depressive properties reported, and to extract them to synthesize a potent neuroprotective drug to treat neurological diseases potentially.
  • ... As non-pharmaceutical treatments, reminiscence therapy and reality orientation are known, but the effects are also not clear and patient compliance is necessary for these treatments. A study has reported an improvement in cognitive function by olfactory stimulation using aromatherapy 1 , and this may be a potential alternative non-pharmaceutical option. Yet, reports on this treatment are limited in Japan, and the effectiveness has not been elucidated. ...
    Article
    Full-text available
    We examined whether symptoms of dementia are improved by olfactory nerve stimulation in Alzheimer type dementia patients. First, a stick‐type olfactory identification ability test was performed in patients with Alzheimer type dementia, to select patients without olfactory dysfunctions. Then, these patients were randomly assigned into the intervention (n = 19) and the control groups (n = 17). To evaluate the effects of olfactory nerve stimulation, we exposed the intervention group to a disinfecting ethanol with added aroma extracts from ceder and the control group to the ethanol without the added aroma extracts. Each group underwent the intervention for 8 weeks, cognitive and behavioral functions were evaluated before and after treatments using the Neuropsychiatric Inventory (NPI), the Japanese version of Zarit Caregiver Burden interview (J‐ZBI), and the Alzheimer's Disease Assessment Scale‐cognitive subscale (ADAS‐cog). A significant improvement was observed in the NPI score and J‐ZBI in the intervention group compared to the control group at 4 and 8 weeks. On the other hand, there was no significant difference in the score of ADAS‐cog. Exposure to cedar fragrance improved behavioral and psychological symptoms of dementia (BPSD) in Alzheimer type dementia and may reduce the burden of nursing care. In addition to its effectiveness, the procedure is simple and minimally invasive and would be a valuable non‐pharmaceutical treatment.
  • ... [22][23][24][25][26][27][28] A technology-aided program for supporting engagement in daily activities, for example, may involve the use of a tablet that reminds the participants of the activities to carry out (ie, at the appropriate times of the day) and presents them with the instructions for the activity steps. 26 Behavioral interventions available for persons in the low moderate, or severe stages of the disease may include (1) various forms of environmental stimulation (eg, music stimulation, snoezelen, and aromatherapy) [29][30][31][32][33][34] aimed at reducing problem behavior (eg, agitation) and improving general mood and (2) technology-aided programs aimed at promoting simple responses (eg, arm or leg movements, supported ambulation steps, and basic occupation). [35][36][37][38] Within those programs, responses are automatically followed by preferred stimuli aimed at motivating their repetition and thus bringing about periods of potentially beneficial engagement with minimal staff supervision. ...
    Article
    Objectives: This study assessed a smartphone-based program to promote practical and mildly demanding arm responses and personal satisfaction and increase physical exertion (heart rates) in people with advanced Alzheimer's disease. Methods: The program relied on a Samsung Galaxy A3 smartphone with Android 6.0 operating system. Two groups of 10 and 11 participants, respectively, were assigned different responses (ie, placing cards into an elevated box and moving bottles with water from a table into a container). Responses activated the smartphone, which produced brief periods of preferred stimulation. Lack of responding led the smartphone to produce a verbal prompt. Results: All participants had significant increases in independent response frequencies, level of personal satisfaction, and heart rates during program sessions as opposed to baseline or control sessions. Conclusion: A smartphone-based program may help people with advanced Alzheimer's disease increase independent occupation with possible benefits in terms of satisfaction and physical condition.
  • ... Essential oils (EOs) from natural resources and volatile compounds are expected to have therapeutic effects on AD. 6 Two effects of EO for the improvement of AD are known: aroma therapeutic and enzyme inhibitory effects. 7,8 The aroma therapeutic effect is attributed to the relaxing effect caused by inhaling an aromatic substance, while the enzyme inhibitory effect is attributed to the inhibition of enzymes related to AD and the deterioration of symptoms. In particular, the constituents of EO are often small molecules that possess lipophilicity. ...
    Article
    Full-text available
    Panax ginseng C.A. Meyer is recognized as one of the most important crude drugs in ancient Chinese medicine. Numerous pharmacological studies investigated P. ginseng; however, these studies were limited to ginsenosides, which are typical constituents in P. ginseng. We focused on the essential oil (EO) from P. ginseng as it has a typical aroma. Herein, we report the inhibitory activities of EO against β-secretase, acetylcholinesterase (AChE), and butyrylcholinesterase (BChE), which were investigated in order to demonstrate the potential of EO as a preventative and therapeutic agent against Alzheimer’s disease (AD). Essential oil (250 µg/mL) showed 41.4% inhibition against β-secretase, 77.4% inhibition against AChE, and 94.1% inhibition against BChE. In addition, spathulenol (8.82%, content % in EO), bicyclogermacrene (6.23%), β-elemene (3.94%), and α-humulene (3.69%) were identified as high content by Gas chromatography mass spectrometry (GC/MS) analysis. Furthermore, β-elemene and α-humulene showed high activity among 3 compounds with 50% inhibitory concentration (IC 50 ) values of 77.2 and 137.3 µM for AChE, and 298.2 and >2000 µM for BChE, respectively. In this report, we showed the inhibitory activity of EO from P. ginseng against β-secretase, AChE, and BChE, and demonstrated that EO could be a candidate to treat AD. This is the first research to report the anti-AD effect of EO and determination of its volatile components. Especially, β-elemene and α-humulene are expected to be highly bio-available compounds due to their small molecular size and lipophilicity. From these results, EO from P. ginseng may be a promising candidate for AD treatment.
  • ... Selected monoterpenoids from thyme, Spanish sage and lavender EOs, are reported to inhibit AChE in vitro and some in vivo (Houghton, Ren, & Howes, 2006;Mukherjee, Kumar, Mal, & Houghton, 2007;Williams, Sorribas, & Howes, 2011). Many studies, including clinical trials with AD demented patients, have reported beneficial effects from the therapeutic use of EOs (Jimbo, Kimura, Taniguchi, Inoue, & Urakami, 2009;Yoshiyama, Arita, & Suzuki, 2015). ...
    Article
    Full-text available
    Aromatherapy with essential oils (EOs) has been linked to improvement of cognitive function in patients with dementia. In order to act systemically, active EO components must be absorbed through the skin, enter the systemic circulation, and cross the blood brain barrier (BBB). Thus, the aim of this work was to develop quantitative structure activity relationships (QSARs), to predict skin and blood barrier penetrative abilities of 119 terpenoids from EOs used in aromatherapy. The first model was based on experimentally measured skin permeability for 162 molecules, and the second model on BBB permeability for 138 molecules. Each molecule was encoded with 63 calculated molecular descriptors and an artificial neural network was used to correlate molecular descriptors to permeabilities. Developed QSAR models confirm that EOs components penetrate through the skin and across the BBB. Some well-known descriptors, such as log P (lipophilicity), molecular size and shape, dominated the QSAR model for BBB permeability. Compounds with the highest predicted BBB penetration were hydrocarbon terpenes with the smallest molecular size and highest lipophilicity. Thus, molecular size is a limiting factor for penetration. Compounds with the highest skin permeability have slightly higher molecular size, high lipophilicity and low polarity. Our work shows that a major disadvantage of novel multitarget compounds developed for the treatment of Alzheimer’s disease is the size of molecules, which cause problems in their delivery to the brain. Therefore, there is a need for smaller compounds, which possess more desirable physicochemical properties and pharmacokinetics, in addition to targeted biological effects. Communicated by Ramaswamy H. Sarma
  • ... This also agrees with previous report that RO improved long-term memory and inhibited the AChE activity of rat brain (Ozarowski et al., 2013). These results may also explain the observed effectiveness of rosemary aromatherapy in human (Jimbo et al., 2009). ...
    Article
    Full-text available
    Alzheimer’s disease is characterized by progressive degeneration of cortical and hippocampal neurons. This study aims to characterize the metabolic profiles of the hydro-ethanolic extracts of Bacopa monnieri L. (BM) and Rosmarinus officinalis L. (RO) cultivated in Egypt via UPLC–ESI/MS analyses and reveal their possible mechanism of the prophylactic effect(s) on neuro-degeneration in rat model of Alzheimer’s disease (AD). Here, UPLC–ESI/MS analyses were employed for the characterization of hydro-ethanolic extracts. Forty-two male albino rats were intra-peritoneally injected with Aluminum chloride at a dose of 4.2 mg/kg to induce AD. The extracts of BM and RO were separately orally administered at doses of 300 and 450 mg/kg, and Donazil® was orally administered at dose 2.5 mg/kg. Serum levels of malondialdehyde (MDA), and total antioxidant capacity (TAC) were measured using ELISA. Further, Amyloid β-protein, acetylcholinesterase (AChE), τ-protein and serotonin levels were measured in brain tissue using ELISA. The UPLC–ESI/MS analyses revealed the presence of fifteen and seventeen active metabolites in BM and RO extracts respectively which may account for their effects on neuro-degeneration. Serum level of MDA, amyloid β-protein, AChE and τ-protein were significantly decreased in herbal treated groups when compared to AD group (P value < 0.0001). On the other hand, TAC and serotonin levels were significantly elevated in groups treated with BM and RO compared to AD group (P value < 0.0001). Consequently, BM and RO extracts were found to have a potential neuroprotective effect in AD rat model due to their variety of active metabolites.
  • Article
    Full-text available
    Alzheimer’s disease (AD) is related to cognitive impairment, dementia observed generally in aged population due to neurodegeneration in an ongoing manner. It gradually worsens memory power of the patient. The hallmark diagnosis features includes formation of senile plaques and Neurofibrillary tangles (NFT’S) [1, 2]. Too little availability of Acetyl choline (ACh) a neurotransmitter in the cerebral region due to metabolism by an enzyme Acetyl choline esterase before showing its action and neural death are the primary reasons for AD. There are many categories of Anti-Alzheimer’s drugs available for management of AD in the market but due to lack of patient compliance successful outcomes were not observed [3]. Apart from this including Nutraceuticals in diet daily routine, Aromatherapy, modifications in the regular schedule, practicing yoga regularly relaxes mind and body from tensions, insomnia, blood circulation, detoxification of organs due to rhythmic breathings and reduce frequency of incidence of headache are proven to show best results by relieving stress according to survey[4-9]. At present herbal medicine has turn out to be best choice for the management of AD because of its availability, very economic, good patient compliance, ease of formulation and lower deleterious side effects [10, 11]. Novel techniques can be used for the development of herbal medicine. This review totally discuses about the occurrence of AD, its Pathophysiology, different stages in the disorder, various selective therapeutic targets for AD, available Anti-AD herbal drugs such as Curcumin, Withania somnifera, Bhrami, Ginkgo biloba, guggul, ginseng, herbs with essential oils, volatile oils, source and cultivation of the herbs, mechanism of action of the Phytochemicals in the herb responsible for treating AD. Keywords: Alzheimer’s disease (AD), cognitive impairment, Dementia, Senile plaques, Nutraceuticals, Herbal medicine, Phytoconstituents.
  • Article
    Changes in the aging process affect the duration and quality of sleep. Not having a quality night's sleep leads to a reduction in daytime wakefulness in older adults. We examined the effect of aromatherapy on the cognitive functions and daytime sleepiness of older adults living in a nursing home. The research was a pretest and posttest design, which was conducted without a control group. The sample included 39 elders. A rosemary-lemon oil mixture was smelled by elders in the mornings for a week. After a 1-week washout period, lavender oils were smelled in the evenings for a week. After application of the rosemary-lemon oil mixture, the mean score of participants' daytime sleepiness was lower, but that decline was not statistically meaningful (P > .050). After the same application, the mean score of the participants' cognitive functions was significantly lower (P < .001). After application of lavender oil, the scores were significantly lower (P < .001). Lower scores on the scales used indicate lower sleepiness. The results showed that the 2 applications can be used to improve cognitive functions in older adults; in addition, lavender oil has an advantage in reducing daytime sleepiness.
  • Article
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    This paper aimed to review the potential for archival items to be used to support therapeutic interventions in dementia care, with a particular focus on olfactory stimuli. Archival research was used to identify objects and to re-create authentic historical product fragrances from Boots UK. Potentially therapeutic material and smells for people living with dementia were identified and olfactory profiles created. These were characterized by strong smells and items featuring well-known brands and distinctive packaging including carbolic soap and Old English Lavender talcum powder. A dataset of items has been created for use in future research studies.
  • Article
    To assess the quality of research evidence for the different activity components for the psycho-social Namaste Care intervention for care home residents with advanced dementia.
  • Article
    Purpose: We hypothesized that lavender oil inhalation, before orthognathic surgery, would have an anxiolytic effect on patients. Materials and methods: We executed a single-blinded, randomized, prospective study. The study comprised 90 patients (43 men and 47 women) scheduled to undergo orthognathic surgery (bilateral sagittal split, Le Fort I, and bimaxillary osteotomies). The patients were exposed to different concentrations of lavender oil diffusions in 120 mL of water during a 1-hour period before surgery (group 1, 0.1-mL oil diffusion; group 2, 0.3-mL oil diffusion; and group 3, no oil). The predictor variable was the State-Trait Anxiety Inventory (STAI). The STAI-2 was used to assess trait anxiety scores, and the STAI-1 was used to assess state anxiety scores at the time of admittance (STAI-1-A) and after 1 hour, before operating room transfer (STAI-1-OR). We performed a χ2 analysis for categorical variables, 1-way analysis of variance for continuous variables, and paired-samples t test for patients' state and trait anxiety levels. The P value was set at .05. Results: No significant differences were found between groups concerning gender, age, working status, educational background, and surgical operation to be performed. When the demographic data and STAI scores were compared, the STAI-2 scores of patients in group 3 aged between 18 and 30 years and high school graduates were significantly higher. The mean trait anxiety scores were significantly higher in group 2 than in group 1. The STAI-1-OR scores in all 3 groups were significantly higher than the STAI-1-A scores. However, no statistically significant difference was found between the groups. Conclusions: The results of this study suggested that 1 hour of presurgical inhalation of 0.1-mL and 0.3-mL lavender oil diffusions in 120 mL of water did not have an anxiolytic effect on patients undergoing orthognathic surgery. Future studies will focus on different concentrations, different inhalation times, and higher study samples.
  • Article
    Aims and objectives: This study evaluates the clinical effectiveness of a multi-component aroma-massage with an acupressure treatment protocol and compared it to cognitive training for the management of BPSD. Background: Pharmacological interventions have been unsatisfactory in managing BPSD; thus, complementary and alternative medicine has been extensively researched to identify an adjunct safe and cost-effective intervention. Design: This RCT utilized a three-arm parallel group design. Cognitive training was used as a conventional intervention to manage BPSD, whereas exercise was considered "treatment as usual" in this study; both were used as comparisons with the experimental protocol. There were three treatment groups: Group 1: aroma-massage with acupressure + exercise; Group 2: cognitive training + exercise; and Group 3: aroma-massage with acupressure + cognitive training. Method: Sixty older adults were recruited and randomly assigned to the three groups (20 each). Using the 29-item Chinese Version of the Cohen-Mansfield Agitation Inventory, Neuropsychiatric Inventory, Mini-mental State Examination, and Barthel Index-20, the outcome measures were assessed at pre-intervention, post-intervention, and the 3-month follow-up to assess behaviour, ADL, cognition, and BPSD severity and distress. Multiple comparisons performed through repeated measures were analysed to detect between-group differences and within-subject differences, as well as the interaction effects between groups and times. Results: The Group 1 and 3 participants showed a significant reduction in the severity and distress caused by BPSD, whereas group 2 did not demonstrate similar effects. Conclusions: This clinical study suggests that aroma massage with acupressure is as effective as cognitive training and can enhance cognitive training in reducing the severity and distress of BPSD. Relevance to clinical practice: Aroma-massage with acupressure may serve as an adjunct therapy to reduce BPSD. This therapy is safe, cost-effective and can be implemented by caregivers and family members who are not professionally trained. This article is protected by copyright. All rights reserved.
  • Article
    Patients with Alzheimer’s disease (AD) develop olfactory and gustatory disorders. However, the order of failure and relevance of the pathophysiology are unclear. We compared olfactory identification and whole mouth gustation in patients with AD to those with mild cognitive impairment (MCI) and to healthy controls (HC) and assessed correlations with pathophysiology. Patients with AD (n = 40), MCI (n = 34), and HC (n = 40) were recruited. We performed the Odor Stick Identification Test for Japanese (OSIT-J), gustatory test by the intraoral dropping method using taste solutions, Mini-Mental State Examination (MMSE), Alzheimer’s Disease Assessment Scale-cognitive subscale Japanese version (ADAS-J cog), Touch Panel-type Dementia Assessment Scale (TDAS), and measurement of amyloid β (Aβ) 42 and phosphorylated tau (p-tau) 181 levels in cerebrospinal fluid (CSF). Patients with AD and MCI had lower OSIT-J scores than did the HC. The OSIT-J score was correlated with the MMSE, ADAS-J cog, TDAS, and Aβ42 results. There were no significant differences in the gustatory test scores among the three groups. The gustatory test score was only correlated with the MMSE, ADAS-J cog, and TDAS results. Olfactory function decreased in AD and MCI patients and was associated with CSF biomarker levels and cognitive disorders. The results suggest that olfactory function is impaired in early stage of AD. Gustatory function was not correlated with CSF biomarkers, which suggests that it may not be impaired in early stage of AD.
  • Article
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    Alzheimer’s disease (AD) is by far the most prevalent of all known forms of dementia. Despite wide-spread research, the main causes of emergence and development of AD have not been fully recognized. Natural, low-molecular, lipophilic terpenoids constitute an interesting group of secondary plant metabolites, that exert biological activities of possible use in the prevention and treatment of AD. In order to identify secondary metabolites possessing both antioxidant activity and the potential to increase the level of acetylcholine, selected terpenoids have been screened for possible acetylcholinesterase inhibitory activity by use of two methods, namely Marston (chromatographic assay) and Ellman (spectrophotometric assay). In order to describe the interaction between terpenes and AChE active gorge, molecular docking simulations were performed. Additionally, all analyzed terpenes were also evaluated for their cytotoxic properties against two normal cell lines using MTT assay. The obtained results show that: carvone (6), pulegone (8) and
  • Article
    Essential oil from Rosmarinus officinalis (Rosemary essential oil, EORO) may improve cognitive function by activating the central nervous system. However, no scientific basis for the effect of EORO has been described. Therefore, we investigated the effect of EORO on Alzheimer's type dementia using model mice. Mice were administered EORO by inhalation. Then, scopolamine was used to prepare Alzheimer's type dementia model mice. To evaluate cognitive function, the Y‐maze test was used for assessment of short‐term memory. EORO produced a significant improvement in the rate of spontaneous alternation behavior. Furthermore, 1,8‐cineole, α‐pinene, and β‐pinene, the main components of EORO, were detected in the brain in a concentration‐dependent manner following inhalation of EORO. Thus, inhalation of EORO may improve cognitive function in a model of Alzheimer's type dementia. Components such as 1,8‐cineole and others are likely involved in the effects on the brain. Examination of the detailed mechanism of action of EORO is necessary for future clinical application. Effect of rosemary essential oil on Alzheimer's dementia model mice by administration of scopolamine (2 mg/kg i.p.). spontaneous alternation behavior (%). Data are presented as the mean ± standard error (n = 5) ***p <0.001. EORO 4 i.h.: inhaled administration of rosemary essential oil (4 μL/L air). Water i.h.: inhaled administration of water (negative control)
  • Chapter
    Alzheimer's disease (AD),a neurodegenerative disorder associated with memory and cognition impairment, is mostly prevalent among the elderly population and leads to death of patients. The formation of amyloid‐beta (Aβ) plaques and neurofibrillary tangles (NFTs) in brain tissues, hyperphosphorylation of tau protein in neurons and formation of reactive oxygen species (ROS) are associated with disease pathogenesis. Apart from the inhibition of the enzyme acetylcholinesterase (AChE); there are other noncholinergic therapeutic approaches, including antioxidant based treatment , vitamin therapy, stem cell therapy, hormonal therapy, use of antihypertensive or lipid‐lowering medications,selective inhibition of phosphodiesterase (PDE), β‐secretase, γ‐secretase, Aβ aggregation and tau hyperphosphorylation. Medicinal plants as well as plant‐derived botanicals are examined for anti‐AD activity in several preclinical and clinical trialsalong with many traditional reports. In this current approach, the underlying mechanism of disease onset is discussed along with the therapeutic effects of different phytochemicals and traditional herbal formulations in both crude and synergistic forms. The biotechnological advancement, genetic transformation ,statistical aspects of anti‐AD activity of plant secondary metabolites and their source botanicals are discussed with associated experimental animal model and cell lines.
  • Article
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    Citrus aurantifolia (Christm.) Swingle (syn. C. MEDICA var. ACIDA Brandis) (family: Rutaceae) essential oil is one of the cheapest oils found in local markets. Although, it is generally accepted as non-toxic to vital organs and cells, majority of people are cynical about it usage. Herein, the present study reports the chemical composition and in vivo oral toxicity study of unripe C. aurantifolia essential oil found in Ghana. The toxicity of C. aurantifolia essential oil extract was investigated via oral administration using two methods: The acute toxicity single dose study (SDS) and the repeated dose method. The oil exhibited no acute toxicity but in the sub-chronic studies, the effects was dose and time-dependent. Chemical profile investigation of the oil showed 9 constituent of phytochemicals (Germacrene isomers (61.2%), Pineen (14%), Linalool dimmer (2.9%), Bornane (11%), Citral (2.9%), Anethole (1.5%), Anisole (1.1%), Safrole (0.3%) and Demitol (0.6%)). Histopathological studies revealed conditions such as necrosis, edema and inflammatory reaction in the liver, spleen and kidneys. Marginal upsurge of biochemical parameters above normal and elevated levels of lymphocytes (35.20-46.40 g/dL) demonstrated mild toxicity among the 100 mg/kg and 500 mg/kg dose groups at the sub-chronic stage. Low levels of hemoglobin (13.60 to 12.70 g/dL), MCV (34.20-24.0 fL), MCH (40.20-36.40 g/dL) along with high levels of liver enzymes confirmed the mild toxicity of the oil at sub-chronic stage. These results demonstrate that, despite consideration of lime essential oil as safe, it can have mild hematotoxic, nephrotoxic and hepatotoxic effects.
  • Article
    Background: Alzheimer's Disease (AD) accounts for approximately 50% of all cases of dementia and, in spite of the great effort for the development of disease-modifying drugs, a definitive treatment of cognitive impairment is not available yet. A perfect adherence to the current therapy of cognitive decline is needed for a better control of the disease and this is proven to reduce, though not completely abolish, the associated Behavioural and Psychological Symptoms of Dementia (BPSDs) from occurring. This cluster of symptoms, remarkably affecting patients' health-related quality of life (HRQL), is tightly associated to pain states. Antipsychotics are the only treatment for BPSDs. However, these drugs are more effective and safer in the short-term (6-12 weeks), they are able to manage aggression but not agitation and they cannot control pain. Aromatherapy with Melissa officinalis and Lavandula officinalis has been employed to handle BPSDs, but it has not provided strong evidence to offer relief from pain. 1.2. Objective: Bergamot Essential Oil (BEO) exerts antinociceptive activity through several pharmacological mechanisms: in particular, it is able to enhance autophagy, a process undergoing derangement in chronic pain. Thus, the sound pharmacological basis for clinical translation of aromatherapy with BEO in the treatment of BPSDs has been pointed out. 1.3. Conclusion: The antinociceptive effects elicited by BEO in experimental pain models make of it a possible candidate for the pharmacological management of pain-related BPSDs.
  • Article
    The purpose of this review was to explore the effectiveness of sensory-based interventions for clients with dementia and Alzheimer’s disease living in residential facilities. Nine databases and key sources were searched from 2002 to September 2017. Forty-seven articles met the inclusion criteria. There was strong evidence for use of massage. There was moderate evidence for occupationally and environmentally based multisensory activities including light, gardening, mealtime, music, Montessori, animal assisted therapy, dance, and yoga interventions. There was inconclusive evidence for aromatherapy, art, Snoezelen rooms, and combined visual and auditory interventions. Future research should focus on defining protocols for efficacious interventions.
  • Chapter
    Die Abnahme der verbalen Fähigkeiten, der Orientierung und der Sinneswahrnehmung führt im Verlauf einer kognitiven Beeinträchtigung zu Problemen, die das selbstständige Bewältigen des Alltages für die Betroffenen zunehmend erschweren. Je stärker dies zunimmt, umso wichtiger wird bei diesen Themen die Unterstützung durch die Betreuer. Einige dieser Themen wie Kontinenz, Appetit und Essen, Schmerz und Angst, die im Alter und insbesondere im Zusammenhang mit einer Demenz auftreten können, werden kurz skizziert – ohne Anspruch auf Vollständigkeit. Das Zusammenspiel von seelischer Verfassung und körperlicher Befindlichkeit lässt Rückschlüsse von der einen auf die andere Ebene. Schmerz und Angst drücken sich immer auch körperlich und seelisch aus. Daher ist die Pflege des Körpers wie Waschen und Kleiden oder die Nahrungsaufnahme immer unter beiden Aspekten zu betrachten.
  • Article
    Aromatherapy has both psychological and physiological effects on a person's mind and/or body. The psychological effect is produced by alteration of brain activity through the olfactory stimulation from sense of smell. The physiological response is produced by the pharmacological effect of chemical substances in the essential oil. This review introduces profiles of essential oils and discuss their possible application to rehabilitation.
  • Article
    The Lantana camara species is generally seen only as a detriment to plantations, but there is also its medicinal potential. This work aims to analyze the essential oil (EO) yield and its chemical composition of fresh and dry leaves versus the seasonal variation of L. camara, as well as its inhibition of fungi, bacteria and on the enzyme acetylcholinesterase. Thus, the variations in the yield of the EO and its chemical composition in front of the aforementioned variation are notorious. The EO of the fresh and dry leaves throughout the day (6 am, 12 pm and 6 pm) presented inhibition of Candida albicans higher than the standards. However, what is clear is that the EO of the dry leaves of L. camara were the best inhibitors of fungi, bacteria and also on the enzyme of acetylcholinesterase, this stands out its potent inhibition in 96.10%, superior to the standard used (90.31%).
  • Article
    The purposes of this study were to produce prototypes of new chemo-mechanical caries removal reagents that contained bromelain and orange oil and to evaluate their effectiveness and quality for caries removal and the influence on resin filling after caries removal. Sixty extracted human permanent teeth with cervical dentinal caries were used in this study. BO reagent I containing 10% bromelain and 10% orange oil and BO reagent II containing 10% bromelain and 20% orange oil were produced for this study. All specimens were classified into three groups and for each group either BO reagents or Carisolv were used to remove caries. After caries removal, all specimens in each group were divided into 5 non-EDTA and 15 EDTA treatment teeth. The cavity surfaces of 5 non-EDTA and 5 EDTA treatment teeth were observed by stereomicroscopy and scanning electron microscopy (SEM). Other specimens were filled with resin composite and 5 teeth were selected in each group, and then a micro-leakage test was performed. After the micro-leakage test, all samples were longitudinally bisected with a diamond saw disc, and observed by stereomicroscopy and SEM. Five residual teeth in each group were immersed in 4 N HCL to resolve dentin and the condition of their resin tag was observed by SEM. No significant difference in surface structure was found among the three groups. The surfaces of non-EDTA treatment cavities showed a remaining smear layer in all groups, while the smear layer had been completely removed after EDTA treatment. The results of the micro-leakage test of each group were also equivalent. Sufficient bonding between resin composite and dentin was confirmed in all groups by SEM. The time required for caries removal by treatment with BO reagents was shorter than that by Carisolv treatment where BO reagent II showed the statistically shortest time. The presence of resin tags was confirmed by SEM in all groups. These results indicated that BO reagents can remove caries and do not influence the bonding between resin composite and dentin. In conclusion, the new reagent, especially BO reagent II, is expected to be an effective agent for caries removal.
  • Article
    There is growing evidence that aromatherapy can improve mood. Since pharmacists may be requested to counsel patients about aromatherapy, this study was designed to evaluate the influence of counseling on the effectiveness of aromatherapy in 14 healthy young women. Participants completed a self-reported questionnaire (motivation, feeling of drowsiness and general fatigue) and multi-dimensional fatigue inventory-20 (MFI-20) in a room filled with the fragrance of bergamot, with or without counseling. Further, as an objective measure of changes in stress, blood flow in the inferior frontal cortex was evaluated by means of near-infrared spectroscopy (NIRS). MFI-20 showed that aromatherapy with counseling significantly improved activity and motivation, as compared to aromatherapy only. The self-reported questionnaire showed no significant difference. Regional blood flow in the inferior frontal cortex was significantly decreased by exposure to aromatherapy with counseling, compared to aromatherapy alone (p<0.01, p<0.05). The value of the laterality index (LI) derived from NIRS measurements, which is considered to be a measure of stress, was decreased by aromatherapy with counseling, indicating that bergamot oil reduces stress. Overall, the results indicated that counseling intervention markedly increased the effectiveness of aromatherapy.
  • A new rating scale for Alzhe-imer's disease
    • Mohs Rc Davis
    • Kl
    Rosen WG, Mohs RC, Davis KL. A new rating scale for Alzhe-imer's disease. Am J Psychiatry 1984; 141: 1356–1364.
  • Functional assessment staging (FAST) in Alzheimer's disease: Reliability, validity, ordinality. Int Psycho-geriatr 1992
    • Sclan
    • Sg
    22 Sclan SG, Reisberg B. Functional assessment staging (FAST) in Alzheimer's disease: Reliability, validity, ordinality. Int Psycho-geriatr 1992; 4: 55–69.
  • Article
    Eighty-three brains obtained at autopsy from nondemented and demented individuals were examined for extracellular amyloid deposits and intraneuronal neurofibrillary changes. The distribution pattern and packing density of amyloid deposits turned out to be of limited significance for differentiation of neuropathological stages. Neurofibrillary changes occurred in the form of neuritic plaques, neurofibrillary tangles and neuropil threads. The distribution of neuritic plaques varied widely not only within architectonic units but also from one individual to another. Neurofibrillary tangles and neuropil threads, in contrast, exhibited a characteristic distribution pattern permitting the differentiation of six stages. The first two stages were characterized by an either mild or severe alteration of the transentorhinal layer Pre-alpha (transentorhinal stages I-II). The two forms of limbic stages (stages III-IV) were marked by a conspicuous affection of layer Pre-alpha in both transentorhinal region and proper entorhinal cortex. In addition, there was mild involvement of the first Ammon's horn sector. The hallmark of the two isocortical stages (stages V-VI) was the destruction of virtually all isocortical association areas. The investigation showed that recognition of the six stages required qualitative evaluation of only a few key preparations.
  • Article
    Criteria for the diagnosis of vascular dementia (VaD) that are reliable, valid, and readily applicable in a variety of settings are urgently needed for both clinical and research purposes. To address this need, the Neuroepidemiology Branch of the National Institute of Neurological Disorders and Stroke (NINDS) convened an International Workshop with support from the Association Internationale pour la Recherche et l'Enseignement en Neurosciences (AIREN), resulting in research criteria for the diagnosis of VaD. Compared with other current criteria, these guidelines emphasize (1) the heterogeneity of vascular dementia syndromes and pathologic subtypes including ischemic and hemorrhagic strokes, cerebral hypoxic-ischemic events, and senile leukoencephalopathic lesions; (2) the variability in clinical course, which may be static, remitting, or progressive; (3) specific clinical findings early in the course (eg, gait disorder, incontinence, or mood and personality changes) that support a vascular rather than a degenerative cause; (4) the need to establish a temporal relationship between stroke and dementia onset for a secure diagnosis; (5) the importance of brain imaging to support clinical findings; (6) the value of neuropsychological testing to document impairments in multiple cognitive domains; and (7) a protocol for neuropathologic evaluations and correlative studies of clinical, radiologic, and neuropsychological features. These criteria are intended as a guide for case definition in neuroepidemiologic studies, stratified by levels of certainty (definite, probable, and possible). They await testing and validation and will be revised as more information becomes available.
  • Article
    Background: Many researchers theorize that animal-assisted therapy (AAT) will have an effect on people suffering from the symptoms of dementia by evaluating short-term-effects. The purpose of this research was to evaluate the psychological and behavioral effects of AAT on elderly residents of a nursing home on a long-term basis. Methods: The subjects consisted of 10 residents of a residential nursing home. Researchers first created each participant’s goal in an agreement with the nursing home staff. Visits were made twice a month, and on each occasion three or four dogs were taken. The residents were able to freely feed, hold and play with the dogs, with each dog placed on a separate table. Data collection methods included GBS Scale Japanese Version (GBSS-J) and Mental Function Impairment Scale (MENFIS). Data was collected four times during the period 2003–05. The scores were analyzed using SPSS11.5J. Results: According to GBSS-J, the scores for intellectual function, spontaneity, emotional function and other mental functions decreased during the first 6 months of the study and then increased until the twelfth month. The score for Motor function increased over the 12 months. When comparisons were made item by item, there were significant decreases in impaired orientation in space, and emotional liability during the first 6 months. According to MENFIS, the overall score tended to decrease during the first 6-month period but increased from 6 months to 12 months. There was a tendency for scores to decrease in impaired emotional function, especially impaired suitability of emotional expression and impaired stability of emotional expression over the 12-month period. Conclusions: After 6 months of participation in AAT, there were improvements in mental functions, though physical functions decreased. It is suggested that after a 6 month period each subject’s needs and goals should be re-examined.
  • Article
    Background:  Preventing the progression of dementia is a widespread challenge. However, currently there is limited evidence supporting the effectiveness of dementia rehabilitation.Methods:  We practiced activity reminiscence therapy (ART) as brain-activating rehabilitation for both lucid and demented persons (n = 18) in a day-service setting as well as in a group home. The ART sessions were conducted 1 hour every week for 12 weeks (intervention period). We compared the results of three cognitive tests (the Mini-Mental State Examination, the Kana Pick-out test and the ‘logical memory’ component of the Wechsler Memory Scale-Revised) and four behavior and caregiver's burden scales (the Clinical Dementia Rating, the Multidimensional Observation Scale for Elderly Subjects, the Dementia Behavior Disturbance scale and the Zarit Caregiver Burden Interview) conducted during the control period with those taken during the intervention period. At the end of the intervention period, we interviewed the staff and families individually to assess whether the participants seemed to have changed after intervention and, if so, how.Results:  In cognitive tests, only immediate and delayed recall of the Wechsler Memory Scale-Revised showed significant improvement. None of the four behavior and caregiver's burden scales showed any significant changes after intervention. However, the interviews showed improvements in subjective aspects of communication, interaction and behavior.Conclusion:  ART uses old-style tools. The nostalgia brought about by using these familiar tools led to effective recall of experiences, in which the participants taught the staff how to use the tools, which were unfamiliar to the staff. Through this role-reversal, they gained a sense of self-worth and a desire to live. Due to the reconstructed relationship between participants and caregivers, we consider ART to be effective in maintaining and improving emotional functions, activities of daily living and memory. ART should be useful for both lucid and mildly demented persons as brain-activating rehabilitation therapy.
  • Abstract  Despite a rapid increase in disabled elderly in Japan, the burden of the caregiver has not been properly assessed due to a lack of objective measurements. Our study was aimed at adapting and validating the Zarit Caregiver Burden Interview (ZBI) in Japan, which is one of the most widely used measurements for caregivers' burden in the United States. Sixty-six caregivers answered the self-administered questionnaire, involving the Japanese version of the ZBI and questions regarding their caregiving situation. Our study demonstrated that the Japanese version of the ZBI had equally as high reliability and validity as the original version. The Japanese ZBI had a high test—retest reliability (r = 0.76) and internal consistency (Cronbach's alpha = 0.93). The total score of the ZBI was highly correlated with the caregivers' score of the Center for Epidemiologic Studies Depression Scale (CES-D) score (r = 0.50), as well as a single global rating of burden (r = 0.71). It was also shown that demographic distribution of the score of the Japanese version had a similar trend to that of the original version. Caregivers who looked after patients with behavioral disturbances were found to have a significantly higher ZBI score than those who looked alter patients without behavioral disturbances, which is consistent with previous findings. It is concluded that the Japanese version of the ZBI can be used to measure feelings of burden of caregivers in the Japanese population and can be used for cross-cultural comparison.
  • Article
    Background: While there is a growing interest in cognitive rehabilitation for older adults, not enough data is available regarding its feasibility and effectiveness in an older population. The present study implemented a home-based cognitive rehabilitation program for older adults in order to explore the program’s feasibility and effectiveness.Methods: The 8-month rehabilitation program consisted of multiple workbooks targeted at improving attention, memory and executive function. Study participants worked on the workbooks at home with family members, while professional cognitive rehabilitation staff periodically evaluated their progress. Attention, memory and executive function were evaluated at outset, at month 4 and at the end of month 8.Results: The nine initial participants had histories of subarachnoid hemorrhage or traumatic brain injury, or were outpatients of a memory clinic who had memory impairment. Six participants (66.7%) completed the 8-month program; one subject intentionally withdrew from the program while two others withdrew due to hospitalization. Among the six remaining participants, attention improved significantly between the month 4 and month 8 evaluations, and between the initial and month 8 evaluations. Within subsets of the attention test, significant improvement was seen in the visual selective attention domain. There was no change in memory or executive function, as well as the subjective difficulties in daily lives.Conclusions: This study suggests that a home-based cognitive rehabilitation program for older adults is feasible and may improve attention, especially visual selective attention. An 8-month rehabilitation program may have been of insufficient duration to generate significant improvements in memory or executive function.
  • Article
    Evaluation of changes in functional performance and activities of daily living skills is an essential aspect of the assessment of elderly individuals with chronic illness. Although functional decrement is a central aspect of Alzheimer's disease (AD), many measures currently utilized to assess these changes have limitations. Empirical and systematic examination of the functional changes occurring in patients with AD has resulted in the development of an assessment measure termed Functional Assessment Staging (FAST) that allows for the specific evaluation of these changes throughout the entire course of AD. In this paper the results of three separate investigations regarding the reliability, validity, and progressive ordinality of FAST are described. The results indicate that FAST is a reliable and valid assessment technique for evaluating functional deterioration in AD patients throughout the entire course of the illness. Moreover, the results suggest that the FAST elucidates a characteristic pattern of progressive, ordinal, and functional decline in AD. Because the elements of functional capacity incorporated in FAST are relatively universal and readily ascertainable, as well as characteristic of the course of AD, FAST can serve as a strong diagnostic and differential diagnostic aid for clinicians. The sensitivity of FAST to the entire course of AD, even in its most severe stages, may be indicative of the potential value of this instrument for further investigation of the temporal longitudinal course of AD, and of the relationships between clinical pathology and neuropathology throughout the entire longitudinal course of AD.
  • Article
    Eighty-three brains obtained at autopsy from nondemented and demented individuals were examined for extracellular amyloid deposits and intraneuronal neurofibrillary changes. The distribution pattern and packing density of amyloid deposits turned out to be of limited significance for differentiation of neuropathological stages. Neurofibrillary changes occurred in the form of neuritic plaques, neurofibrillary tangles and neuropil threads. The distribution of neuritic plaques varied widely not only within architectonic units but also from one individual to another. Neurofibrillary tangles and neuropil threads, in contrast, exhibited a characteristic distribution pattern permitting the differentiation of six stages. The first two stages were characterized by an either mild or severe alteration of the transentorhinal layer Pre-alpha (transentorhinal stages I-II). The two forms of limbic stages (stages III-IV) were marked by a conspicuous affection of layer Pre-alpha in both transentorhinal region and proper entorhinal cortex. In addition, there was mild involvement of the first Ammon's horn sector. The hallmark of the two isocortical stages (stages V-VI) was the destruction of virtually all isocortical association areas. The investigation showed that recognition of the six stages required qualitative evaluation of only a few key preparations.
  • Article
    GBS scale with four subscales and 26 total items is a behavior rating scale for dementia syndromes, and is now being used as one of the measures to assess the effects of drug therapy in dementia in Japan. In this article, the reliability and validity of the Japanese version of GBS Scale (GBSS-J) in 246 patients with dementia are examined. Two pairs of raters independently rated 20 patients to test inter-rater reliability of the 26 items. Pearson's correlation coefficients indicated good agreement between the raters except for nine items. The validity of the 26 items was examined by comparing them with the Functional Assessment Staging. Physical disability was evaluated by the Rapid Disability Rating Scale. Twenty items of GBSS-J measured the severity of dementia with sufficient validity. In addition, the items of eating, impaired physical activity, impaired wakefulness, and irritability were related to severity of physical disability rather than to dementia by the results from an analysis of variance and covariance. Although internal reliabilities by Cronbach's alpha of the three subscales were relatively high except for the subscale of different symptoms common in dementia, a factor analysis of the 26 items raised questions concerning the construct validity of the original four subscales.
  • Article
    Full-text available
    A new rating instrument, the Alzheimer's Disease Assessment Scale, was designed specifically to evaluate the severity of cognitive and noncognitive behavioral dysfunctions characteristic of persons with Alzheimer's disease. Item descriptions, administration procedures, and scoring are outlined. Twenty-seven subjects with Alzheimer's disease and 28 normal elderly subjects were rated on 40 items. Twenty-one items with significant intraclass correlation coefficients for interrater reliability (range, .650-.989) and significant Spearman rank-order correlation coefficients for test-retest reliability (range, .514-1) constitute the final scale. Subjects with Alzheimer's disease had significantly more cognitive and noncognitive dysfunction than the normal elderly subjects.
  • Article
    Clinical criteria for the diagnosis of Alzheimer's disease include insidious onset and progressive impairment of memory and other cognitive functions. There are no motor, sensory, or coordination deficits early in the disease. The diagnosis cannot be determined by laboratory tests. These tests are important primarily in identifying other possible causes of dementia that must be excluded before the diagnosis of Alzheimer's disease may be made with confidence. Neuropsychological tests provide confirmatory evidence of the diagnosis of dementia and help to assess the course and response to therapy. The criteria proposed are intended to serve as a guide for the diagnosis of probable, possible, and definite Alzheimer's disease; these criteria will be revised as more definitive information become available.
  • Article
    In 190 patients, we studied changes in intellectual status during perioperative period using Hasegawa's Dementia Scale (HDS-R), and analyzed preoperative, intraoperative, and postoperative risk factors. HDS-R is one of the most popular scoring tests for evaluating dementia or delirium. Risk factors impairing preoperative score were aging, and preoperative complications including cerebral vascular disease, old myocardial infarction, arrythmia, and diabetes mellitus. Risk factors impairing postoperative score were, in addition to above-mentioned factors, hypoproteinemia and postoperative stressful conditions such as prolonged fever, pain, bed rest, and naso-gastric tube. In the patients who showed postoperative score deterioration, the incidence of old myocardial infarction, hypertension, and postoperative stressful conditions was significantly greater. In the patients who showed postoperative score improvement, local anesthesia including epidural and spinal anesthesia was used more often. In conclusion, aging or preoperative complications such as cerebral vascular disease, old myocardial infarction, arrythmia, and diabetes mellitus are high risks for the development of postoperative dementia and delirium under general surgical procedures and general anesthesia. Intraoperative management with patients awake using local anesthesia and postoperative stress-less conditions are important to avoid postoperative dementia.
  • Article
    We carried out two separate epidemiological studies on long-term changes, 10 years apart, on the prevalence rate of dementia in the elderly by the same method for the same area in Japan. We also performed a genetic study of patients with dementia of the Alzheimer type (DAT) based on the epidemiological studies. The number of patients with dementia was much larger in 1990 than in 1980. Especially, the number of mildly demented patients was significantly larger in 1990 than in 1980. The 35 patients with DAT did not show any mutations of amyloid-beta protein precursor, presenilin 1 and presenilin 2 genes. The frequency of apolipoprotein E (apo E) sigma4 allele in DAT was significantly higher than that in control subjects (p < 0.005). This study suggests that the frequency of DAT may increase by aging of the population in the future and we confirm the close association between apoE sigma4 allele and DAT in a community-based study in Japan.
  • Article
    Full-text available
    The genesis of new cells, including neurons, in the adult human brain has not yet been demonstrated. This study was undertaken to investigate whether neurogenesis occurs in the adult human brain, in regions previously identified as neurogenic in adult rodents and monkeys. Human brain tissue was obtained postmortem from patients who had been treated with the thymidine analog, bromodeoxyuridine (BrdU), that labels DNA during the S phase. Using immunofluorescent labeling for BrdU and for one of the neuronal markers, NeuN, calbindin or neuron specific enolase (NSE), we demonstrate that new neurons, as defined by these markers, are generated from dividing progenitor cells in the dentate gyrus of adult humans. Our results further indicate that the human hippocampus retains its ability to generate neurons throughout life.
  • Article
    Several studies have demonstrated a good correlation between clinical severity and Braak's neuropathological staging in Alzheimer's disease (AD). However, nonagenarians and centenarians display a different pattern of cortical vulnerability to the neurodegenerative process compared to younger elderly, and it is not known whether correlations between clinical severity and neuropathological stages remain valid in this age group. To address this issue we compared Clinical Dementia Rating scale (CDR) scores and Braak stages in 116 patients over 90 years of age with either no cognitive impairment or very mild to severe AD. There is a strong positive correlation between CDR scores and Braak staging (Spearman coefficient = 0.66; P < 0.01). However, neuropathological staging does not distinguish cases with normal cognition (CDR 0) from those with mild cognitive changes (CDR 0.5). Unlike younger cohorts, Braak stages I and II are frequently associated with questionable dementia in this age group. Braak stage III overlaps with all CDR levels and correlates poorly with cognitive function. Braak stages IV or greater are consistently associated with at least mild dementia. Consistent with our previous neuropathological analyses of nonagenarians and centenarians, the present data suggest that the substantial involvement of the hippocampus which characterizes Braak stage IV is a key step in the development of overt clinical signs of dementia in the oldest-old. Moreover, they indicate that Braak staging represents a broad concept of the evolution of neurofibrillary tangles rather than a precise hierarchical model associated with a stepwise deterioration of cognitive abilities near the upper limit of life.
  • Article
    We studied the prevalence of dementing disorders in a rural town of Japan (Amino-cho), using a door-to-door two-phase design. Of the 170 persons screened as having cognitive impairment, 142 cases were diagnosed as having dementia. The prevalence (cases/100 aged 65 years older) was 3.8 for all types of dementia, 2.1 for Alzheimer's disease (AD), 1.0 for vascular dementia (VD) and 0.7 for other types of dementia. Among other types of dementia, there were four male patients with dementia with Lewy bodies (prevalence: 0.1), but no patients with frontotemporal lobar degeneration. The overall prevalence was higher in women for AD, while that of VD was the same in both sexes. With results similar to many previous studies in Western countries and some recent surveys in Japan, the present sudy clearly showed that AD is more prevalent than VD.
  • Article
    A random controlled trial of the relaxing effects of an aromatherapy massage on disordered behaviour in dementia was conducted. Twenty-one patients were randomly allocated into one of three conditions, aromatherapy and massage (AM), conversation and aromatherapy (CA) and massage only (M). AM showed the greatest reduction in the frequency of excessive motor behaviour of all three conditions. This reached statistical significance between the hours of three and four pm (p < 0.05). Post hoc analysis suggested that at this time of day the AM consistently reduced motor behaviour when compared with CA (p = 0.05). This provides preliminary evidence of a measurable sedative effect of aromatherapy massage on dementia within a robust scientific paradigm. Further research is recommended with an expanded sample size.
  • Article
    Antioxidative Wirkung von Zitronenöl und seinen Komponeneten auf die Kup-fer-induzierte Oxidation von Low Density Lipoprotein Die Oxidation von Low Density Lipo-protein (LDL) wird seit einigen Jahren mit der Atherogenese in Verbindung ge-bracht. Daher wird von vielen Arbeits-gruppen nach wirkungsvollen Antioxidantien gesucht, die in der Lage sind, die LDL-Oxidation zu verhindern und so das Atherosklerose-Risiko zu verringern. Be-sonderes Augenmerk gilt dabei verschiedenen Flavonoiden, deren antioxidative Kapazität von unterschiedlichen Fakto-ren abhängt, unter anderem von der Li-pophilic des jeweiligen Flavonoids. Etherische Öle, welche hochlipophil sind, besitzen antioxidative Eigenschaften und wurden daher hinsichtlich ihres Einflusses auf die kupferinduzierte LDL-Oxida-tion untersucht. Dazu wurde Plasma mit verschiedenen Terpenen inkubiert und anschließend LDL isoliert Diese Vorinkubation führt zur Anreicherung der Ter-pene im LDL. Während der kupferinduzierten LDL-Oxidation wurden die Bildung konjugierter Diene und die Ab-nahme der Tryptophanfluoreszenz bestimmt sowie die Antioxidation α-Tocopherol, β-Carotin und Lycopin im LDL quantifiziert. Die stärkste Verzögerung der LDL-Oxidation konnte mit Zitro-nenöl und einer seiner Komponenten,γ -Terpinen, erreicht werden. Dieser Effekt ist unabhängig vom α-Tocopherol-Ver-brauch, die Oxidation der Carotinoide wird hingegen in Anwesenheit von γ-Ter-pinen stark verzögert.
  • Article
    Behavioral and psychological symptoms in dementia are frequent and are 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 with essential oil of Melissa officinalis (lemon balm) for agitation in people with severe dementia. Seventy-two people residing in National Health Service (U.K.) care facilities who had clinically significant agitation in the context of severe dementia were randomly assigned to aromatherapy with Melissa essential oil (N = 36) or placebo (sunflower oil) (N = 36). The active treatment or placebo oil was combined with a base lotion and applied to patients' faces and arms twice a day by caregiving staff. Changes in clinically significant agitation (Cohen-Mansfield Agitation Inventory [CMAI]) and quality of life indices (percentage of time spent socially withdrawn and percentage of time engaged in constructive activities, measured with Dementia Care Mapping) were compared between the 2 groups over a 4-week period of treatment. Seventy-one patients completed the trial. No significant side effects were observed. Sixty percent (21/35) of the active treatment group and 14% (5/36) of the placebo-treated group experienced a 30% reduction of CMAI score, with an overall improvement in agitation (mean reduction in CMAI score) of 35% in patients receiving Melissa balm essential oil and 11% in those treated with placebo (Mann-Whitney U test; Z = 4.1, p < .0001). Quality of life indices also improved significantly more in people receiving essential balm oil (Mann-Whitney U test; percentage of time spent socially withdrawn: Z = 2.6, p = .005; percentage of time engaged in constructive activities: Z = 3.5, p = .001). The finding that 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, indicates the need for further controlled trials.
  • Article
    Full-text available
    This study was designed to assess the olfactory impact of the essential oils of lavender (Lavandula angustifolia) and rosemary (Rosmarlnus officinalis) on cognitive performance and mood in healthy volunteers. One hundred and forty-four participants were randomly assigned to one of three independent groups, and subsequently performed the Cognitive Drug Research (CDR) computerized cognitive assessment battery in a cubicle containing either one of the two odors or no odor (control). Visual analogue mood questionnaires were completed prior to exposure to the odor, and subsequently after completion of the test battery. The participants were deceived as to the genuine aim of the study until the completion of testing to prevent expectancy effects from possibly influencing the data. The outcome variables from the nine tasks that constitute the CDR core battery feed into six factors that represent different aspects of cognitive functioning. Analysis of performance revealed that lavender produced a significant decrement in performance of working memory, and impaired reaction times for both memory and attention based tasks compared to controls. In contrast, rosemary produced a significant enhancement of performance for overall quality of memory and secondary memory factors, but also produced an impairment of speed of memory compared to controls. With regard to mood, comparisons of the change in ratings from baseline to post-test revealed that following the completion of the cognitive assessment battery, both the control and lavender groups were significantly less alert than the rosemary condition; however, the control group was significantly less content than both rosemary and lavender conditions. These findings indicate that the olfactory properties of these essential oils can produce objective effects on cognitive performance, as well as subjective effects on mood.
  • Article
    To clarify the olfactory deficit hypothesis regarding Alzheimer's disease, the authors compared olfactory function in patients with Alzheimer's disease, subjects with mild cognitive impairment, and healthy comparison subjects. Olfactory function of 14 patients with mild Alzheimer's disease, eight subjects with mild cognitive impairment, and eight healthy age-matched comparison subjects was assessed with both psychophysical tests and olfactory event-related potentials. Group comparison of the psychophysical test results showed a significant main effect of diagnosis for odor detection threshold, odor discrimination, and odor identification. These results correlated only partially with those obtained from olfactory event-related potentials. Seven Alzheimer's disease patients and four with mild cognitive impairment showed no olfactory event-related potentials, suggesting hyposmia, while all comparison subjects had clearly discernible responses. Patients with Alzheimer's disease were significantly more likely to be nonresponders. In the four Alzheimer's disease patients and four subjects with mild cognitive impairment who had clear electrophysiological responses, amplitudes and latencies of the various event-related potential components were normal, i.e., similar to those of the comparison subjects, although 12 of the 14 Alzheimer's disease patients and seven of the eight mildly impaired subjects were classified as functionally anosmic with psychophysical methods. The electrophysiological results confirm prior findings of olfactory dysfunction in patients with Alzheimer's disease and preclinical Alzheimer's disease. Investigations of larger study groups with detailed cognitive examination and postmortem diagnosis may resolve the intriguing possibility of early diagnosis and discrimination of Alzheimer's disease subtypes through chemosensory event-related potentials in addition to existing biomarkers.
  • Article
    This study was designed to verify the effect of aromatherapy on a postpartum mother's perineal healing. The research design was a clinical trial. The methods of aromatherapy were applied sitz bath or soap application using essential oils with Lavender, Myrrh, Neroli, Rose, Grapefruit, Mandarin, Orange, and Roman Chamomile. The subjects of this experiment were postpartum mothers who delivered vaginally with an episiotomy. They were allocated to one of three groups; the aroma-sitz bath group, aroma-soap application group or control group. To evaluate the effect of aromatherapy, the perineal healing status was measured using the REEDA scale and smears of episiotomy wound were obtained. The data were analyzed by repeated measures of ANOVA, ANCOVA, chi2-test, and multiple response analysis via SPSS program. The REEDA scale was significantly low in the experimental group at postpartum 5th and 7th days (P=.009, P=.003), respectively. Most were observed 'few'(5-10 bacteria per field) bacteria in the smears of episiotomy wound. The one bacteria was identified in the 50.8% of subjects in pretest and two bacteria in the 60.3% in posttest. Most frequently identified bacteria were Escherichia coli and Enterococcus faecalis. In conclusion, these findings indicate that postpartum aromatherapy for perineal care could be effective in healing the perineum perineal care could be effective in healing the perineum.
  • Article
    The use of aromatherapy in nursing care continues to be popular in many settings. Most of the nursing literature relates to the use of essential oils in low doses for massage or use of the oils as environmental fragrances. Information from the wider literature may add to the evidence base for use of this therapy in nursing. This paper reports a literature relating to the use of aromatherapy by nurses and critically evaluates the evidence to support this practice. Medline, CINAHL, MANTIS and EBSCO Host databases were searched for papers related to use of essential oils and/or aromatherapy. Papers were also obtained through cross-checking of reference lists. A total of 165 articles have been included in this review. Nursing papers were published since 1990 were included, but some references from 1971 onwards relating to scientific research conducted on essential oils were also included. These remain valuable as they are probably the only reference available for a specific oil or property, or show the development of knowledge in this area. Papers were excluded if they consisted only of brief case studies presented in abstract form. The review covers key professional issues and the principal areas of clinical practice where aromatherapy is used. Despite calls for more research in the 1980s and 1990s, there is still little empirical evidence to support the use of aromatherapy in nursing practice beyond enhancing relaxation. Its popularity needs to be balanced against the potential risks related to allergies, safety and inappropriate use by inexperienced users. There is great potential for more collaborative research by nurses to explore the clinical applications in greater detail and to move beyond the low dose paradigm of application of essential oils.
  • Article
    Although thousands of new neurons are continuously produced in the dentate gyrus of rodents each day, the function of these newborn cells remains unclear. An increasing number of reports have provided correlational evidence that adult hippocampal neurogenesis is involved in learning and memory. Exposure of animals to an enriched environment leads to improvement of performance in several learning tasks and enhances neurogenesis specifically in the hippocampus. These data raise the question of whether new neurons participate in memory improvement induced by enrichment. To address this issue, we have examined whether the increase in the number of surviving adult-generated cells following environmental enrichment contributes to improved memory function. To this end, neurogenesis was substantially reduced throughout the environmental enrichment period using the antimitotic agent methylazoxymethanol acetate (MAM). Recognition memory performance of MAM-treated enriched rats was evaluated in a novel object recognition task and compared with that of naive and nontreated enriched rats. Injections of 5-bromo-2'-deoxyuridine were used to label dividing cells, together with double immunofluorescent labelling using glial or neuronal cell-specific markers. We found that enrichment led to improved long-term recognition memory and increased hippocampal neurogenesis, and that MAM treatment during environmental enrichment completely prevented both the increase in neurogenesis and enrichment-induced long-term memory improvement. These results establish that newborn cells in the dentate gyrus contribute to the expression of the promnesic effects of behavioural enrichment, and they provide further support for the idea that adult-generated neurons participate in modulating memory function.
  • Article
    Cerebral deposition of beta-amyloid (Abeta) peptides is an invariant pathological hallmark in brains of patients with Alzheimer's disease (AD) and transgenic mice coexpressing familial AD-linked APP and PS1 variants. We now report that exposure of transgenic mice to an "enriched environment" results in pronounced reductions in cerebral Abeta levels and amyloid deposits, compared to animals raised under "standard housing" conditions. The enzymatic activity of an Abeta-degrading endopeptidase, neprilysin, is elevated in the brains of "enriched" mice and inversely correlated with amyloid burden. Moreover, DNA microarray analysis revealed selective upregulation in levels of transcripts encoded by genes associated with learning and memory, vasculogenesis, neurogenesis, cell survival pathways, Abeta sequestration, and prostaglandin synthesis. These studies provide evidence that environmental enrichment leads to reductions in steady-state levels of cerebral Abeta peptides and amyloid deposition and selective upregulation in levels of specific transcripts in brains of transgenic mice.
  • Article
    This study was to develop an aromatherapy hand massage program, and to evaluate the effects of lavender aromatherapy on cognitive function, emotion, and aggressive behavior of elderly with dementia of the Alzheimer's type. The Research design was a nonequivalent control group non-synchronized quasiexperimental study. Lavender aromatherapy was administrated to experimental group I for 2 weeks, jojoba oil massage was administrated to experimental group II for 2 weeks, and no treatment was administrated to the control group for 2 weeks. Data was analyzed using the chi(2)-test, ANOVA, repeated measures of ANCOVA and ANCOVA in the SPSS program package. 1. Experimental group I did not show significant differences in cognitive function in relation to the experimental group II and control group. 2. Experimental group I showed significant differences in emotion and aggressive behavior in relation to the experimental group II and control group. A Lavender aromatherapy hand massage program is effective on emotions and aggressive behavior of elderly with dementia of the Alzheimer's type.
  • Article
    A number of medicinal plants are traditionally endowed with anxiolytic or sedative properties and, in the context of this revue, both indications are considered since the former may induce a mood conducive to the latter. For any sleep-inducing drug to be effective, a tranquil ambience needs to be established a priori. Thus, physical ailments (i.e. pain), factors interfering with sleep (i.e. noise), psychological conditions causing stress, psychiatric illnesses (i.e. depression) and other drugs that interfere with sleep (i.e. caffeine) need to be controlled, if possible. Kava-kava is a well-established hypnotic drug, with a rapid onset of effect, adequate duration of action and minimal morning after-effects. However, reports of serious hepatotoxicity with this preparation have led to it being banned in most countries worldwide. On the other hand, side-effects with valerian would appear to be bland indeed. However, it's slow onset of effect (2-3 weeks) renders it unsuitable for short-term use (i.e. 'jet-lag'), but it does have profound beneficial effects on sleep architecture (augments deep sleep) that may make it particularly suitable for long-term use and for the elderly. In a personal trial (not double-blind) in stress-induced insomnia, both kava and valerian improved sleep and the ill-effects of stress, and the combination of the two was even more effective for the control of insomnia. Aromatherapy (lavender, chamomile, Ylang-Ylang) would appear to improve sleep, but how practical a form of treatment this may be remains to be determined. The only other plant drug that may have some effect on sleep is melissa, but reports are too scanty to form any opinion about this. Based on animal experiments, passion flower (passiflora) may have a sedative action, but the sedative action of hops has not been investigated in any detail. In conclusion, there is a need for longer-term controlled studies with some of these compounds (particularly valerian). Aromatherapy constitutes a tantalising possibility. In the interpretation of this review, it should be borne in mind that the evidence on which it is based is often incomplete or missing, but that is all that is available. Consequently some conjecture on the part of the author is inevitable and should be appreciated as such.
  • Article
    Insomnia is the most common of all sleep complaints and is under-researched. The current treatments of choice are conventional hypnotics agents, but these have potential for serious adverse reactions. Uncontrolled and anecdotal evidence suggests that lavender oil is an effective treatment for insomnia, but this has not been formally investigated. The aims of this study were to evaluate the proposed trial methodology and the efficacy of Lavandula augustifolia (lavender) on insomnia. Interventions: Interventions consisted of Lavandula augustifolia (treatment) and sweet almond oil as placebo/control. The aroma was supplied via an Aromastream device (Tisserand Aromatherapy, Sussex, UK). This was a pilot study with randomized, single-blind, cross-over design (baseline, two treatment periods, and a washout period, each of 1 week duration). Volunteers with defined insomnia treated on a domiciliary basis participated in the study. Outcomes were assessed with the following: Pittsburgh Sleep Quality Index (PSQI) indicating insomnia (score > 5 at entry); Borkovec and Nau (B&N) Questionnaire evaluating treatment credibility; and Holistic Complementary and Alternative Medicine Questionnaire (HCAMQ) assessing attitudes to CAM and health beliefs. Ten (10) volunteers (5 male and 5 female) were entered and completed the 4 week study. Lavender created an improvement of -2.5 points in PSQI (p = 0.07, 95% CI - 4.95 to - 0.4). Each intervention was equally credible and belief in CAM did not predict outcome. Women and younger volunteers with a milder insomnia improved more than others. No period or carry-over effect was observed. The methodology for this pilot study appeared to be appropriate. Outcomes favor lavender, and a larger trial is required to draw definitive conclusions.