Yang et al.BMC Complementary and Alternative Medicine (2015)15:93 D0110.1186/512906-015-0612-9 BMC Complementary Alternative Medicine RESEARCH ARTICLE Open Access Comparison of the efficacy of aroma-acupressure and aromatherapy for the treatment of dementia-associated agitation Man-Hua Yang',Li-Chan Lin2,Shiao-Chi Wu3,Jen-Hwey Chiu,Pei-Ning Wang and Jaung-Geng Lin Abstract Background:One of the most common symptoms observed in patients with dementia is agitation,and several non-pharmacological treatments have been used to control this symptom.However,because of limitations in research design,the benefit of non-pharmacological treatments has only been demonstrated in certain cases. The purpose of this study was to compare aroma-acupressure and aromatherapy with respect to their effects on agitation in patients with dementia. Methods:In this experimental study,the participants were randomly assigned to three groups:56 patients were included in the aroma-acupressure group,73 patients in the aromatherapy group,and 57 patients in the control group who received daily routine as usual without intervention.The Cohen-Mansfield Agitation Inventory (CMAl) scale and the heart rate variability (HRV)index were used to assess differences in agitation.The CMAl was used in the pre-test,post-test and post-three-week test,and the HRV was used in the pre-test,the post-test and the post-three-week test as well as every week during the four-week interventions. Results:The CMAI scores were significantly lower in the aroma-acupressure and aromatherapy groups compared with the control group in the post-test and post-three-week assessments.Sympathetic nervous activity was significantly lower in the fourth week in the aroma-acupressure group and in the second week in the aromatherapy group,whereas parasympathetic nervous activity increased from the second week to the fourth week in the aroma-acupressure group and in the fourth week in the aromatherapy group. Conclusions:Aroma-acupressure had a greater effect than aromatherapy on agitation in patients with dementia. However,agitation was improved in both of the groups,which allowed the patients with dementia to become more relaxed.Future studies should continue to assess the benefits of aroma-acupressure and aromatherapy for the treatment of agitation in dementia patients. Trial registration:ChiCTR-TRC-14004810;Date of registration:2014/6/12 Keywords:Dementia,Agitation,Aroma-acupressure,Aromatherapy Background and agitation in patients with dementia.However,the Agitation is one of the most commonly observed symp-number of side effects associated with these drugs has toms in dementia patients.Agitation includes inappro- increased,and cerebrovascular adverse events,including priate physical and verbal actions that cause trouble for stroke,have been noted in elderly patients with demen- family members and caregivers and can even lead to lost tia taking first-generation or second-generation anti- work and other financial burdens.Antipsychotics have psychotic drugs [1].Compared with pharmacological generally been effective for the treatment of psychosis treatments,non-pharmacological treatments,such as acupressure and aromatherapy,have ameliorated agita- Correspondence:lichan@ym.edu.tw tion and cognitive impairment in dementia patients 2Institute of Clinical and Community Health Nursing.National Yang-Ming [2-4].Non-pharmacological treatments are non-invasive, University,155,Li-Nong Street Sec 2,Beitou District,Taipei 11221,Taiwan have fewer side effects and are safer to use [5].Although Full list of author information is available at the end of the article 2015 Yang et al:licensee BioMed Central.This is an Open Access article distributed under the terms of the Creative BioMed Central oaanwmpog8ea9e3pepreae8m2msoond Dedication waiver (http//creativecommons.org/publicdomain/zero/1.0/)applies to the data made available in this article, unless otherwise stated.R E S EAR CH A R TIC L E Open Access Comparison of the efficacy of aroma-acupressure and aromatherapy for the treatment of dementia-associated agitation Man-Hua Yang1 , Li-Chan Lin2*, Shiao-Chi Wu3 , Jen-Hwey Chiu4 , Pei-Ning Wang5 and Jaung-Geng Lin6 Abstract Background: One of the most common symptoms observed in patients with dementia is agitation, and several non-pharmacological treatments have been used to control this symptom. However, because of limitations in research design, the benefit of non-pharmacological treatments has only been demonstrated in certain cases. The purpose of this study was to compare aroma-acupressure and aromatherapy with respect to their effects on agitation in patients with dementia. Methods: In this experimental study, the participants were randomly assigned to three groups: 56 patients were included in the aroma-acupressure group, 73 patients in the aromatherapy group, and 57 patients in the control group who received daily routine as usual without intervention. The Cohen-Mansfield Agitation Inventory (CMAI) scale and the heart rate variability (HRV) index were used to assess differences in agitation. The CMAI was used in the pre-test, post-test and post-three-week test, and the HRV was used in the pre-test, the post-test and the post-three-week test as well as every week during the four-week interventions. Results: The CMAI scores were significantly lower in the aroma-acupressure and aromatherapy groups compared with the control group in the post-test and post-three-week assessments. Sympathetic nervous activity was significantly lower in the fourth week in the aroma-acupressure group and in the second week in the aromatherapy group, whereas parasympathetic nervous activity increased from the second week to the fourth week in the aroma-acupressure group and in the fourth week in the aromatherapy group. Conclusions: Aroma-acupressure had a greater effect than aromatherapy on agitation in patients with dementia. However, agitation was improved in both of the groups, which allowed the patients with dementia to become more relaxed. Future studies should continue to assess the benefits of aroma-acupressure and aromatherapy for the treatment of agitation in dementia patients. Trial registration: ChiCTR-TRC-14004810; Date of registration: 2014/6/12 Keywords: Dementia, Agitation, Aroma-acupressure, Aromatherapy Background Agitation is one of the most commonly observed symp￾toms in dementia patients. Agitation includes inappro￾priate physical and verbal actions that cause trouble for family members and caregivers and can even lead to lost work and other financial burdens. Antipsychotics have generally been effective for the treatment of psychosis and agitation in patients with dementia. However, the number of side effects associated with these drugs has increased, and cerebrovascular adverse events, including stroke, have been noted in elderly patients with demen￾tia taking first-generation or second-generation anti￾psychotic drugs [1]. Compared with pharmacological treatments, non-pharmacological treatments, such as acupressure and aromatherapy, have ameliorated agita￾tion and cognitive impairment in dementia patients [2-4]. Non-pharmacological treatments are non-invasive, have fewer side effects and are safer to use [5]. Although * Correspondence: lichan@ym.edu.tw 2 Institute of Clinical and Community Health Nursing, National Yang-Ming University, 155, Li-Nong Street Sec 2, Beitou District, Taipei 11221, Taiwan Full list of author information is available at the end of the article © 2015 Yang et al.; licensee BioMed Central. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. Yang et al. BMC Complementary and Alternative Medicine (2015) 15:93 DOI 10.1186/s12906-015-0612-9