Effect of aromatherapy on patients with Alzheimer's disease

ArticleinPsychogeriatrics 9(4):173-9 · December 2009with 555 Reads
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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  • ... 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. ...
    ... 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. ...
    ... RCT (16week) 15 mg cap saffron(twice daily) or placebo 46 patients with mild to moderate AD Saffron has significantly better outcome than placebo ( Akhondzadeh et al., 2010a) Crocus sativus double blind RCT Herbal combination(9gr twice daily) or placebo Mood disorders which candidate for electroconvulsive therapy Improvement in impaired memory ( Akuchekian et al., 2012) Lavender crossover method with washout period 28 days Part of aromatherapy*** 28 elderly people(17 of whom had AD) significant improvement in personal orientation related to cognitive function ( Jimbo et al., 2009) Lavender Cross-over study Lavender or lemon odor 1****.Ninety first year psychology undergraduates participated 2. Forty-eight undergraduate subjects Contextdependent retrieval in free recall and spatial learning ( Parker et al., 2001) ...
    Article
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    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.
  • ... While antipsychotic drugs may cause fatal side effects including pneumonia, stroke, and myocardial infarc- tion, 18,45 most studies where aromatherapy was applied have re- ported no side effects. 20,21,46 Caregiver distress according to the NPI was lower in the inter- vention 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 pa- tients staying at home. However, Jimbo et al. 46 analyzed the effects of aromatherapy on patients' cognitive function and nurses' care- giver 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.
  • ... While improvement in sleep disturbance symptoms might be expected to be accompanied by improvements in other BPSD that have their origins in sleep disturbance, no improvement in NPI score, which indicates the level of BPSD, was seen among the present subjects. Jimbo et al. [25] administered inhalation aromatherapy to elderly subjects with Alzheimer-type dementia and examined changes in cognitive function scores. They administered inhalation aromatherapy to promote wakefulness during the daytime and tranquility at night for 24 h and reported significant improvements in cognitive function scores. ...
    ... The present study only applied inhalation aromatherapy at night because of the focus on sleep disturbance symptoms. Jimbo et al. [25] also reported that cognitive function improved as a result of aromatherapy rather than as a result of improvement in sleep disturbance, which may explain why the results of the present study were not in agreement. As daytime sleep data were not able to be collected in the present study, investigation into the relationship between daytime and nighttime sleeping is needed. ...
    Article
    Full-text available
    This study investigated the effects of inhalation aromatherapy on sleep disturbance in elderly individuals with dementia. In 19 subjects, normal sleep was observed for a 20-day control period, inhalation aromatherapy was then applied for a 20-day intervention period, and the control and intervention periods were compared. During the intervention period, essential oils were placed nightly on towels around the subjects’ pillows. The measured sleep conditions were sleep latency, total sleep time, sleep efficacy, duration of the longest sustained sleep period, wake time after sleep onset, early morning awakening, total daytime sleep, and the Neuropsychiatric Inventory. Total sleep time was significantly longer in the intervention period than in the control period ( p<0.05 ). The duration of the longest sustained sleep period was significantly longer in the intervention period than in the control period ( p<0.05 ). Early morning awakening in the intervention period was significantly less compared to that in the control period ( p<0.05 ). Total daytime sleep could not be adequately measured and was omitted from the analysis. No significant differences in other sleep conditions were observed. These results indicated positive effects of inhalation aromatherapy on symptoms of sleep disturbance in elderly individuals with dementia.
  • ... 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 cogni- tive symptoms of patients with moderate or severe dementia is currently limited. ...
    Article
    Full-text available
    This study assessed the effect of continuous ingestion of monosodium l-glutamate (MSG) on cognitive function and dietary score in dementia patients. 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. 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). 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.
  • ... Its stimulating properties on the nervous system have found to be beneficial in hysteria and paralysis. 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]Figure: ...
  • ... 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]. ...
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    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.
  • ... 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. ...
  • ... It was possible to observe improvement in the cognitive function of patients with Alzheimer's through aromatherapy (Savalev et al., 2003). Essential oils act in the central nervous system with excellent results in improving the living conditions and treatment of several diseases, especially neurodegenerative diseases like Alzheimer's and Parkinson (Dobetsberger and Buchbauer, 2011; Jimbo et al., 2009). Filamentous fungi A. flavus and F. proliferatum were inhibited by L. camera essential oil (44.52 and 28.97%, respectively). ...
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    Full-text available
    Lantana camara L. is considered a weed, but is used in agriculture and traditional medicine due to its different pharmacological effects. The objective of this study was to determine the chemical composition and the bioactivity of essential oil from L. camara flowers collected in Boa Vista, Roraima, Brazil. Essential oil was obtained using a Clevenger type apparatus. The oil obtained was analyzed by gas chromatography coupled to flame ionization detector (GC-FID) and gas chromatography coupled to mass spectrometer detector (GC-MS) and its bioactivity was assayed against fungi and bacteria, as well as for acetylcholinesterase inhibition. The chemical composition of essential oil presented major compounds contrasting with the literature, while its bactericidal and fungicidal activity was excellent, reaching over than 90% inhibition against yeast. A potent anti-acetylcholinesterase activity, superior than 77% inhibition, was also observed.
  • ... This aromatherapy regimen significantly improved cog- nitive function, although the magnitude of any individual contribution from rosemary oil cannot be assessed. 52 Collectively considering these human inhalation studies, it would be helpful for future studies not only to better quantitate doses of oil inhaled, but also to measure inter- nal levels of absorbed rosemary oil chemical constituents that could be used as markers of exposure among sub- jects. For example, blood levels of myrcene, 1,8-cineole, or >-pinene might be considered for this purpose. ...
    Article
    The rosemary plant, Rosmarinus officinalis L (family Lamiaceae), is an aromatic evergreen shrub originating in the Mediterranean region and now growing widely in Europe, Asia, and Africa. This plant has been used extensively as a culinary spice in a variety of contexts. Rosemary and its extracts also are used as food preservatives and enhancers of sensory and functional properties. Today, research attention is focusing more closely on whether this herb may have potential to alleviate complications of obesity and diabetes, inflammation-associated conditions, and neurological deficits.
  • ... 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.
  • ... Average heart rate declined again when the slight scent of chrysanthemum was added to the room. In existing studies on the effects of aroma therapy on the behavior and cognition of dementia patients, experiments exposed subjects to a scent for over 2 hr (Jimbo, Kimura, Taniguchi, Inoue, & Urakami, 2009, Holmes et al., 2002, whereas subjects of this study were exposed to the scent for only 15 min. Despite their short exposure to the scent, average heart rate went down as low as average heart rate when the garden was viewed with open doors. ...
    Article
    Full-text available
    Purpose: This study is to examine how viewing a Japanese garden affects Japanese patients with dementia. Background: In a previous study, authors explored the effect on individuals with Alzheimer's disease of viewing an indoor Japanese garden at a nursing home in the United States and reported that viewing the garden significantly reduced the heart rate, evoked short-term and long-term memories, and improved behavioral symptoms. However, it was unclear whether these effects were caused by the design of Japanese garden or unfamiliarity of the design to Caucasians. Methods: We constructed a Japanese garden on the rooftop of a hospital in Japan and assessed with a total of 25 subjects on the following categories: (1) eye movement, (2) heart rate, and (3) behavior under four different conditions: (a) open view of the site before construction of the Japanese garden (the control space), (b) open view of the Japanese garden, (c) view of the Japanese garden through closed door, and (d) view of Japanese garden through closed door with the chrysanthemum scent. Findings/Results: Viewers' eyes scanned larger area while viewing the Japanese garden, and viewing the Japanese garden significantly reduced heart rate and improved behavioral symptoms than the control space. We also found that the effect of viewing the same Japanese garden differed across three conditions: the view through an open door, a closed door, and a closed door with added scent.
  • ... Music therapy has been found to calm, soothe, and engage individuals with dementia. Aromatherapy [349] Specific aromas are used to elicit certain responses, such as relaxation or alertness. Lemon balm and lavender have been particularly beneficial in dementia treatment. ...
    Thesis
    Full-text available
    Given that, by and large, Information and Communication Technologies (ICTs) are aimed at increasing efficacy of workflows, faster and more accurate transfer of information, and decreasing cumbersome procedures, at least some ICTs are directed towards promoting a high quality of life. Particularly, if technologies are used to enhance services, ensure or increase safety and security, promote independence, and/or facilitate social interaction, they impact domains specifically measured in quality of life assessments. As there is no cure for most dementias, the focus of care is largely on the individual’s quality of life, applying technologies to this area of health and social care would seem an appropriate fit. One of the aims of technology solutions to benefit aging adults is to improve quality of life and capability to live independently and healthily; however, improvements in life quality are difficult to measure, and showing the effectiveness of gerontechnology-based solutions is problematic. This research investigated the quantitative data to see if technology use was indeed a facilitator of increased quality of life. The hypothesis was that the older adults and their caregivers would report a positive influence on their quality of life after using the technologies. The end users gave reports via questionnaires on quality of life while metrics, such as frequency of use of a technology and time of use were recorded through the technology system. The work is based on data collected through the clinical intervention trial, and the courses, publications, independent analysis, and interdisciplinary collaboration during the PhD study. The PhD was with the Department of Electronic Systems at Aalborg University in Aalborg, Denmark. The research has been funded through Aalborg University and the European Union Information and Communication Technology Policy Support Program Pilot Type B Project ISISEMD (Intelligent System for Independent living and SElf-care of seniors with cognitive problems or Mild Dementia). Conclusions drawn from the study show that gerontechnology can indeed have a positive influence on quality of life in dementia care; however, significant effects on life quality were confirmed only in the caregivers. There are still knowledge gaps in evaluating quality of life outcomes from using technology in dementia care, and more homogenous, rigorous studies need to be done in this field. Without careful operationalization of the concept, it will be difficult for researchers to interpret the (clinical) outcomes into meaningful results that can be used by other researchers, caregivers, and medical professionals. Objective: Intervention analysis on the efficacy of telecare services in home-based dementia care after 15 months. Design: Multinational, non-blinded, quasi-experimental, clinical intervention trial (nonpharmacological) Setting: Homes of individuals with dementia in North Ireland, Denmark, Finland, and Greece Participants: From 63 individuals with dementia and their caregivers, 31 intervention dyads are compared to 22 control dyads. Intervention: A telecare system consisting of domotics with a centralized architecture aimed to support safety, independence, and quality of life, and to reduce caregiver burden through the transfer of tasks and care support. Main outcome measures: Physical functioning (ADL and IADL), quality of life (QOL-AD and SQLC), caregiver burden (ZBI) are comparative outcomes, and global responses provide exploratory outcomes in the intervention group. The statistical analysis applies t-tests to verify significant differences in means and Pearson correlations to test for linear relationships within the data, all using 95% Confidence Interval. Results: There is a highly significant difference in caregiver burden between the technology intervention and control groups (p=0,02**). The intervention group showed a non-significant reduction in caregiver burden (p=0,51) while the control group showed a highly significant increase in caregiver burden (p=0,01**). The intervention group shows improvement in home safety (80,6%), a high level of user satisfaction (88,7%), and the majority expresses desire to continue using (90,3%) the telecare services and a willingness to pay for such services (53,2%). Conclusion: This study showed that the use of telecare intervention to support dementia care has protective and positive effects for the informal caregivers, but overall does not measure as performing significantly different than usual care. The evidence suggests telecare can be beneficial but methodology limitations prevent definitive conclusions. Trial registration: The Phase I clinical intervention trial did not require registration. The trial was funded by the European Commission Competitiveness and Innovation Programme - Information and Communication Technology - Policy Support Programme. The pilot type B.2008.1.4 project ISISEMD was executed from 01/03/2009 to 31/08/2011. Reference: CIP-ICT-PSP-2-238914. Trial information can be found at the project website http://www.isisemd.eu/. Full text can be accessed via Aalborg University at http://vbn.aau.dk/en/publications/gerontechnology-outcomes-technology-intervention-on-quality-of-life-in-dementia-care(79f9afd3-eb57-4997-a5ee-a2dacf5990ab).html
  • ... 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 neuro- degenerative 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.
  • ... 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.
  • ... 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], 1,8- cineole [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]. ...
    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.
  • ... Many elderly people suffer from depression related to grief or loneliness. 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. ...
  • ... 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
    This study investigated the anticonvulsant activity of Citrullus colocynthis fruit extract used traditionally in the treatment of convulsion. Albino mice were pretreated with extract in different doses (10, 25, 50, and 100 mg/kg), prior to injection of pentylenetetrazole. Animals received pretreatments with naloxone and flumazenil to further clarify the mechanisms of anticonvulsant action. The total flavonoid content of Citrullus colocynthis extract was also determined. Citrullus colocynthis hydroalcoholic extract with doses 25 and 50 mg/kg prolonged the onset of seizures and decreased the duration compared with control group. Pretreatment by flumazenil could inhibit the effect of Citrullus colocynthis on latency of seizure to some extent and administration of naloxone significantly inhibited changes in latency and duration of seizure produced by Citrullus colocynthis. This study showed that Citrullus colocynthis has significant anticonvulsant effect in pentylenetetrazole-induced seizures in mice, and these effects may be related to its effect on γ-aminobutyric acid-ergic and opioid systems. These results confirmed the traditional use of Citrullus colocynthis in Iranian traditional medicine.
  • ... Epidemiological studies have suggested that aluminum (Al) in drinking water is a risk factor for AD. In recent years, the potential of nonpharmacological therapies such as aromatherapy for the prevention of senile dementia has been studied [5]. The efficacy of aromatherapy has been investigated in clinical trials and in physiological psychology studies and as the animal use alternative. ...
    Article
    Full-text available
    Aromatherapy and plant-based essential oils are widely used as complementary and alternative therapies for symptoms including anxiety. Furthermore, it was reportedly effective for the care of several diseases such as Alzheimer’s disease and depressive illness. To investigate the pharmacological effects of essential oils, we developed an in vitro assay system using immortalized hypothalamic neuronal cells (GT1–7 cells). In this study, we evaluated the effects of essential oils on neuronal death induced by hydrogen peroxide (H 2 O 2 ), aluminum, zinc, or the antagonist of estrogen receptor (tamoxifen). Among tests of various essential oils, we found that H 2 O 2 -induced neuronal death was attenuated by the essential oils of damask rose, eucalyptus, fennel, geranium, ginger, kabosu, mandarin, myrrh, and neroli. Damask rose oil had protective effects against aluminum-induced neurotoxicity, while geranium and rosemary oil showed protective activity against zinc-induced neurotoxicity. In contrast, geranium oil and ginger oil enhanced the neurotoxicity of tamoxifen. Our in vitro assay system could be useful for the neuropharmacological and endocrine pharmacological studies of essential oils.
  • ... 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. ...
  • ... The practice known as Aromatherapy, which began in France in the early 20th century, has been increasing in popularity up to the present day. In medicine, interest in the use of essential oils has grown considerably, such that essential oils are currently used worldwide for the management of chronic pain, depression, anxiety, and cognitive, sleep-, and stress-related disorders (Buchbauer & Jirovetz, 1994; Buckle, 1999 Buckle, , 2004 Edge, 2003; Holmes et al., 2002; Jimbo et al., 2009; Kyle, 2006; Lin et al., 2007; Perry & Perry, 2006; Price & Price, 2007; Smallwood et al., 2001). Essential oils are now extensively utilized in the context of alternative medicine, specifically aromatherapy, and aroma wellness. ...
    Article
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    To elucidate the psychophysiological effect of inhaling essential oils, in this paper, we sought to assess the following 12 essential oils: basil, bergamot, cardamom, cinnamon, juniper, lemon, orange, palmarosa, peppermint, sandalwood, spearmint, and ylang ylang. As these being target odors, we focused on the verbal (semantic) and non-verbal (skin temperature) endpoints of the stimuli. In our experimental design, we managed to assign different behavioral tasks to the participants. The Uchida-Kraepelin test was used as a mental arithmetic task and listening to environmental (natural) sounds as an auditory task. In the verbal study, for an example, we conducted the sensory test twice, once before and once after the task. As a measure of the perceived odor quality in participants after inhalation of a given aroma, we employed a sensory evaluation spectrum. It is a bar graph in which the mean of the difference in score between pre-and post-task inquiry (post minus pre) was plotted against the impression descriptors. Taking into account of the obtained skin temperature changes between pre-and post-task inhalations, the subtle nuances between verbal and non-verbal expressions seen as a function of the two behavioral tasks assigned to the participant suggested that essential oils may have versatile psychophysiological potencies by the nature.
  • ... Lemon, rosemary and peppermint aromatherapy produced similar effects as well. Jimbo, et al [90] identified that effects of a cocktail of essential oils stimulates both the sympathetic and the parasympathetic nervous system of AD patients and improved the ability to form abstract ideas, conceptual understanding, cognitive function and movement. This sensory intervention showed significant reduction in aggressive behavior in elderly AD patients and promoted sleep to reduce anxiety in such patients. ...
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    α -Synuclein ( α -Syn) fibrillation links with Parkinson’s disease (PD) and several related syndromes. It is believed that exposure to the factors which promote fibrillation may induce and progress such neurodegenerative diseases (NDs). Herein, the effects of some wildly used essential oils including Myrtus communis ( M. communis ) on α -Syn fibrillation were examined. M. communis particularly increased α -Syn fibrillation in a concentration dependent manner. Given that applications of M. communis are very extensive in Asian societies, especially Zoroastrians, this study was extended towards its role on α -Syn fibrillation/cytotoxicity. By using a unilamellar vesicle, it was shown that the aggregated species with tendency to perturb membrane were increased in the presence of M. communis . In this regard, the cytotoxicity of α -Syn on SH-SH5Y cells was also increased significantly. Inappropriately, the effects of fibrillation inhibitors, baicalein and cuminaldehyde, were modulated in the presence of M. communis . However, major components of M. communis did not induce fibrillation and also the effect of M. communis was limited on other fibrinogenic proteins. Assuming that essential oils have the ability to pass through the blood brain barrier (BBB) along with the popular attention on aromatherapy for the incurable ND, these findings suggest an implementation of fibrillation tests for essential oils.
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    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
    In this study, we investigated whether Rosemary extract (RE) improved cognitive deficits in repetitive mild Traumatic brain injury (rmTBI) rats and its potential mechanisms. The present results showed that rmTBI caused cognitive deficits, such as increased latency to find platform and decreased time spent in target quadrant in Morris water maze (MWM). These behavioral alterations were accompanying with the increased neuronal degeneration and glial fibrillary acidic protein (GFAP)-positive cells, increased Reactive oxygen species (ROS) generation, decreased activity of Superoxide Dismutase (SOD), Glutathione Peroxidase (GPx) and Catalase (CAT), elevated protein level of IL-1β, IL-6 and TNF-α in hippocampus. Treatment with RE prevented these changes above. Our findings confirmed the effect of rosemary extract on improvement of cognitive deficits and suggested its mechanisms might be mediated by anti-oxidative and anti-inflammatory. Therefore, rosemary extract may be a potential treatment to improve cognitive deficits in rmTBI patients.
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    Non pharmacological therapies cannot be dissociated from specific treatments of the Alzheimer disease. They should be more specific in towards prescription (cognitive functions, depression, anxiety, apathy, motivation), design (according to staff, space and temporality) and most of all, towards the evaluation process. In order to prove the legitimacy of such treatments in nursing homes, one should find the right indicators of efficiency and effectiveness.One of the main objective of nonpharmacological therapies is to improve the resident comfort and keep his last abilities. They should be part of a project of individual care and individual life.In broad outline, intervention can be defined into four main targets: cognitive abilities, the affects, the environment and the care givers, inclu-ding the professionals. It is based on particular techniques and specialised professionals. It involves coordinated actions and a global thinking of the institution.
  • Article
    In Japan, "dementia" attracts a great deal of public attention because the number of patients with dementia is on an alarming increase. People are predominantly interested in treatments and diagnostics; but in fact, the prognoses of these patients is are currently imperfect. Moreover, without operations for normal pressure hydrocephalus and subdural hematoma, there is no drastic remedy. For Alzheimer's disease (AD), we can use acetylcholinesterase inhibitors and N-methyl D-aspartate competitive inhibitors to alleviate the symptoms. But these are no more than symptomatic treatments. In many cases, they will be of no use within a few years. Breakthroughs in non-pharmacological therapies might alleviate this problem. We study such treatments, and have suggested that "aromatherapy" might be useful for cognitive disorders in patients with AD and mild cognitive impairment (MCI). The results have been significant. Moreover, results of additional studies suggested that aromatherapy is effective for other symptoms associated with dementia and MCI. We also examined dysodiasomia in AD patients, and advocate how to diagnosis using an olfactory check. These experiences have led us to think that the olfactory system is a new key to the treatment and easy diagnosis of AD and other dementias.
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    We examined the effects of aromatherapy on agitation in patients with dementia and evaluated related caregiver burden. Patients and their caregivers from two hospitals in Turkey were selected and divided into an intervention group (n = 14) and a control group (n = 14). Patients were stratified according to their dementia phase and intake of antipsychotic medication. The intervention group received aromatherapy via massage and inhalation at home for 4 weeks. The control group received no intervention. Data were collected using the Neuropsychiatric Inventory (NPI), the Cohen-Mansfield Agitation Inventory (CMAI) and the Zarit Burden Interview (ZBI). At 2 and 4 weeks, the NPI scores were significantly lower in the intervention group (p < 0.05). At 4 weeks, the CMAI and ZBI scores were significantly lower in the intervention group (p < 0.05). In conclusion, after aromatherapy, agitation, neuropsychiatric symptoms, and caregiver distress significantly reduced, and aromatherapy prevented caregiver burden increase.
  • 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.
  • Article
    Alzheimer's disease (AD) is a severe, chronic and progressive neurodegenerative disease associated with memory and cognition impairment ultimately leading to death. It is the commonest reason of dementia in elderly populations mostly affecting beyond the age of 65. The pathogenesis is indicated by accumulation of the amyloidbeta (A beta) plaques and neurofibrillary tangles (NFT) in brain tissues and hyperphosphorylation of tau protein in neurons. The main cause is considered to be the formation of reactive oxygen species (ROS) due to oxidative stress. The current treatment provides only symptomatic relief by offering temporary palliative therapy which declines the rate of cognitive impairment associated with AD. Inhibition of the enzyme acetylcholinesterase (AChE) is considered as one of the major therapeutic strategies offering only symptomatic relief and moderate
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    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.
  • 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
    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
    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.
  • 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.
  • 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.
  • 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)
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    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.
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    Full-text available
    Objective To provide an overview of non-pharmacological interventions for behavioural and psychological symptoms in dementia (BPSD). Design Systematic overview of reviews. Data sources PubMed, EMBASE, Cochrane Database of Systematic Reviews, CINAHL and PsycINFO (2009–March 2015). Eligibility criteria Systematic reviews (SRs) that included at least one comparative study evaluating any non-pharmacological intervention, to treat BPSD. Data extraction Eligible studies were selected and data extracted independently by 2 reviewers. The AMSTAR checklist was used to assess the quality of the SRs. Data analysis Extracted data were synthesised using a narrative approach. Results 38 SRs and 142 primary studies were identified, comprising the following categories of non-pharmacological interventions: (1) sensory stimulation interventions (12 SRs, 27 primary studies) that encompassed: acupressure, aromatherapy, massage/touch therapy, light therapy and sensory garden; (2) cognitive/emotion-oriented interventions (33 SRs; 70 primary studies) that included cognitive stimulation, music/dance therapy, dance therapy, snoezelen, transcutaneous electrical nerve stimulation, reminiscence therapy, validation therapy, simulated presence therapy; (3) behaviour management techniques (6 SRs; 32 primary studies) and (4) other therapies (5 SRs, 12 primary studies) comprising exercise therapy, animal-assisted therapy, special care unit and dining room environment-based interventions. Music therapy was effective in reducing agitation (SMD, −0.49; 95% CI −0.82 to −0.17; p=0.003), and anxiety (SMD, −0.64; 95% CI −1.05 to −0.24; p=0.002). Home-based behavioural management techniques, caregiver-based interventions or staff training in communication skills, person-centred care or dementia care mapping with supervision during implementation were found to be effective for symptomatic and severe agitation. Conclusions A large number of non-pharmacological interventions for BPSD were identified. The majority of the studies had great variation in how the same type of intervention was defined and applied, the follow-up duration, the type of outcome measured, usually with modest sample size. Overall, music therapy and behavioural management techniques were effective for reducing BPSD.
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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
    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
    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
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    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.
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    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.
  • Article
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    The research results of the effect of essential oil of rosemary on the human short-term image and numerical memory have been described. The study involved 53 secondary school students (24 boys and 29 girls) aged 13–15 years, residents of the Ukrainian metropolis. Participants were divided into the control group 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 these two groups have been found, while sex differences in uniform groups were absent. Therefore, the essential oil of rosemary has significantly increased the image memory compared to the control. Inhalation of the rosemary essential oil increased the memorization of numbers as well.
  • Article
    Full-text available
    The treatment of agitation and aggression, typical Behavioural and Psychological Symptoms of Dementia (BPSDs) of Alzheimer’s Disease (AD), is one of the most complicated aspects of handling patients suffering from dementia. Currently, the management of these symptoms often associated with an increased pain perception, which notably reduces the patients’ quality of life (QoL), relies on the employment of antipsychotic drugs. Unfortunately, the use of these pharmacological agents has some limits: in the long term, they do not result in being equally effective as in the first weeks of treatment and they present important side effects. Therefore, there is growing interest, supported by clinical evidence, in aromatherapy for the control of agitation, aggression, and psychotic symptoms. Some molecular mechanisms have been proposed to explain the behavioural effects of essential oils, as the whole phytocomplex or the single components, but important basic research effort is still needed. For this reason, rigorous preclinical studies are necessary in order to understand the pharmacological basis of aromatherapy in the treatment of BPSDs and to widen the cluster of effective essential oils in pharmacotherapeutic practice.
  • Objectives: Clinical aromatherapy is a complementary therapy that may be very helpful for elderly dementia care. Aromatherapy may reduce the behavioral and psychological symptoms of dementia (BPSD), improve quality of care, and thus improve the quality of life for people with dementia. In this pilot study, aroma hand massage therapy was used for elderly patients in a medical institution in Japan. The study assessed the effectiveness and safety of clinical aromatherapy as part of routine integrative care among people with dementia in a clinical care setting. Interventions: The randomized, crossover pilot trials were performed among 14 patients with mild-to-moderate dementia older than age 65 years living in a nursing home in Nara, Japan. Participants were divided into two groups and offered, alternately, control therapy and clinical aromatherapy 3 times a week for the 4-week trials. The effects on BPSD and activities of daily living (ADLs) were evaluated quantitatively before and after the study and 4 weeks after the study ended as a follow-up. Observation records were also collected to obtain qualitative data. Results: The quantitative data showed that neither therapy significantly improved the BPSD or ADL results. The qualitative data were classified into four main categories-mood, behavior, verbal communication, and nonverbal communication-reflecting the positive experiences of participants during both therapies. No harmful reactions or changes in medication occurred during the study. Conclusions: This pilot study demonstrated that clinical aromatherapy was clinically safe but did not lead to statistically significant improvements in BPSD or ADL among people with dementia. Further research on therapeutic effects is needed to develop high-quality care with clinical aromatherapy for elderly patients with dementia in Japan and to fully establish evidence for effective and safe practice in health care institutions.
  • 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
    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
    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
    Full-text available
    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.
  • A new rating scale for Alzhe-imer's disease
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    22 Sclan SG, Reisberg B. Functional assessment staging (FAST) in Alzheimer's disease: Reliability, validity, ordinality. Int Psycho-geriatr 1992; 4: 55–69.