Most older people with dementia develop psychiatric symptoms or behavioural disturbances such as agitation, aggression, depression, delusions, wandering, sleep disturbance, and hallucinations. Drugs such as neuroleptics and other sedatives are often prescribed but are associated with side effects.
A wide range of alternative approaches has been tried but reports have essentially been qualitative and based on small numbers of patients. However, two exceptions are aromatherapy and bright light treatment, which have emerged as promising treatments, write the authors.
Three trials on aromatherapy in the last year have reported a significant beneficial effect on agitation compared with placebo with almost complete compliance and no side effects. Lemon balm or lavender oil are the two main agents used and are delivered by either inhalation or skin application.
Three recent trials on bright light therapy have also shown a particularly beneficial effect on sleep disturbance.
People with dementia are among the most vulnerable in our society, say the authors. Symptoms often need to be treated expediently, and drugs, although moderately effective, can be hazardous. Aromatherapy and bright light treatment seem to be safe and effective and may have an important role in managing behavioural problems in people with dementia, they conclude.