more on aromatherapy

Lane Simonian

I was hoping the new book "Alzheimer's, Aromatherapy, and the Sense of Smell" was going to provide many examples of the benefits of aromatherapy for people with Alzheimer's disease as it prepublicity promised, but instead it just provided ths one:

"Once whe I was giving a food massage to a women in her nineties, who hadn't spoken for several years, she blurted  out, 'She is good, Janine,' speaking of herself.  A beautiful moment etched in memory.  Aromatherapy transformed my job."

I can add a few more stories like this:

Mary Knapp, 90, a resident at Beverly Health Care, is one of the dozens of participants in Loy’s study. Each day she wears on her sweater a heart-shaped patch scented with frankincense and grapefruit. Knapp described the scent as “mellow.”

Knapp’s daughter, Mary Langston, of Greenville, said she has noticed a marked change in the past few weeks in her mother’s attention span and ability to better remember relatives in photographs and scrapbooks.

“It’s been nice. It makes it so much easier to sit down and talk to her. As a child, you can’t imagine your parent’s not being able to remember things. But lately, it’s like she has been reborn,” Langston said. “She doesn’t get upset that she can’t remember things. Her attention span certainly has improved and she enjoys being around people more. Noises aren’t as disturbing for her.”

 https://news.ecu.edu/2005/10/18/ecu-therapist-studies-links-between-scent-and-memory/

Benjamin Pearce bases his treatments on experience, rather than science.  Five years ago, he was desperate. He had a resident who was violent and agitated, not responding to any of the usual interventions. Cruising the Internet, Pearce happened on an aromatherapeutic oil called “Peace and Calming.”... The juxtaposition of odors it contains is strangely jarring—a strong bright citrus mixed with the deep musk of patchouli—and seems to activate conflicting repulsions and attractions, as well as a desire to sniff it again.

Pearce purchased the oil, dabbed some on a handkerchief and put that in the pocket of his troublesome resident. He believes that the man, thanks to his dementia, quickly forgot about the source of the odor. Yet as the strange smell continued to waft up from his own shirt pocket, he seemed suddenly alert and more manageable. Aromatherapy is now a part of daily life for Pearce’s residents, from energizing citrus scents in the morning to calming lavender at night.

https://scienceline.org/2011/03/lavender-and-old-lace/

To try to make bathing more pleasant, staff decided to heat the bathroom before taking her in and dry her off with towels fresh from the dryer. They also installed a rolling shade over the sink mirror, as Maggie appeared to be fearful when she saw the person in the mirror.

Another strategy they tried was intensive aromatherapy. Caregivers rubbed the essential oil of lavender on her skin every two hours to surround her in a familiar and comforting scent.

Just in case Maggie was experiencing some level of pain, Clairmont’s staff made sure one of the essential oils that eases muscle stiffness, joint pain, and aches was rubbed into her body first thing in the morning when the elderly tend to be most stiff and uncomfortable.

Staff noticed she had difficulty finding the right word when she wanted to express herself, so they worked hard to understand the particular way her mind tended to find a certain kind of word when reaching to express a completely different one.

All of this required intensive one-on-one time getting to know Maggie very well.

Because Maggie so clearly needed comfort, staff took every opportunity to give her a warm hug or sit or walk with her, holding her hand so that she might feel less alone in this strange new world her brain had drawn her inexorably into. Staff discovered that Christian music gave her joy, so they played it for her frequently.

A couple of weeks passed, and gradually Maggie became calmer and more at ease.

Their efforts were so successful that Maggie was able to go entirely off the lethargy-inducing Ativan she had been taking three times a day. She doesn’t even need it PRN (as needed) anymore. Staff even discover, to their delight, glimpses of joy in Maggie’s eyes.

https://www.providermagazine.com/Monthly-Issue/2012/Pages/0912/Maggie-A-Case-Study-In-Dementia-Care.aspx

 https://www.youtube.com/watch?v=sKN3DGxl06o

https://archive.nytimes.com/newoldage.blogs.nytimes.com/2011/02/15/clearing-the-fog-in-nursing-homes/

https://digital.library.txstate.edu/bitstream/handle/10877/4360/2008%20Evaluation%20of%20Aromatherapy%20in%20Insitutional%20Elder%20Care%20Settings.pdf?sequence=1&isAllowed=y

Three of the greatest benefits of aromatherapy are greater responsiveness, more ease, and less fear.  The following clinical trials partially capture the improvements in being.

Methods: 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 aromatherpay, 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 aromatherpay, and after the washout period.

Results: 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.

Conclusions: 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.

https://onlinelibrary.wiley.com/doi/full/10.1111/j.1479-8301.2009.00299.x

Background: Aromatherapy is a complementary and alternative therapeutic method that has attracted much attention worldwide. Based on the lack of clinical research on the application of aromatherapy in the treatment of Alzheimer’s disease (AD) in China, this study aimed to investigate the effect of aromatherapy in patients with AD. 

Methods: 54 patients with AD were randomly allocated to aromatherapy groups and control groups in a 1:1 ratio. Eventually, 25 patients in the aromatherapy group (two participants discontinued midway) and 26 in the control group (one participant discontinued midway) completed the study. Both groups of patients received conventional treatment and nursing care, and the aromatherapy group received an hour of aromatic inhalation per day for 12 weeks,the control group inhaled only distilled water per day for 12 weeks. The Pittsburgh Sleep Quality Index, Neuropsychiatric Inventory–Brief Questionnaire form, Quality of LifeAlzheimer’s Disease, and four kinds of biochemical indicators were evaluated as outcome measures. 

Results: The Pittsburgh Sleep Quality Index and the Neuropsychiatric Inventory–Brief Questionnaire Form scores decreased, the Quality of Life-Alzheimer’s Disease score improved (P<0.05), the malondialdehyde (MDA) content in serum was slightly reduced, superoxide dismutase (SOD) activity was enhanced (P<0.05), and TNF-α and IL-6 levels were significantly reduced (P<0.05) in the aromatherapy group, compared to those of the control group. 

Conclusion: Aromatherapy can improve sleep, alleviate psychobehavioural symptoms and improve quality of life in patients with AD, which may be related to reducing the level of oxidative stress in patients and inhibiting inflammatory factors; it is a non-drug intervention that can be widely applied.

https://assets.researchsquare.com/files/rs-1392290/v1/f79b84f0-ba44-49fd-ace1-57fbb9eac13d.pdf?c=1652156064

Best Wishes to all of you,

Lane

RIM

I follow Lane’s recommendations w/o aromatherapy.  I have my 93 yr old father (MCI) inhale Sage essential one on each side of the nose, once to twice a day.  His memory did improve.

At a higher dose, it dramatically worsened his cognition.   

Ed1937

Thanks, Lane. That's helpful. I'd like to hear more about that.

Lane Simonian

Thank you Ed and RIM for your comments.

Olfactory receptors are g protein coupled receptors and the over-stimulation of g protein-coupled receptors can worsen memory.  A few seconds of direct inhalation under each nostril once or twice a day is probably all one needs to see improvements.  Diffusers can often be run for an hour or two because they disperse essential oil compounds, but they seem to be more effective for relaxation than for cognitive stimulation.  Essential oils such as lavender, sweet orange, and patchouli help reduce agitation and improve sleep at night, whereas essential oils such as bay laurel, rosemary, and sage help improve cognition.

Neurons can be regenerated in the olfactory bulb and hippocampus.  To a certain extent, then, both smell and certain types of memory can be regenerated as well.  Memories are not likely lost in Alzheimer's disease, they cannot be retrieved.  Oxidation and nitration damage a variety of g protein-coupled receptors including those needed for the retrieval of memories, sleep, mood, social recognition, and alertness.  That damage can be partially reversed with certain essential oils via aromatherapy.

Areas of possible improvement with aromatherapy include better sleep, greater alertness and awareness, fewer delusions, recognition of faces, remembering ones name, object recogntion, recognition of places including ones home, less anxiety, and less fear.  When combined with personal care, aromatherapy can thus lead to "significant improvement in personal orientation related to cognitive function."

​fesk

Lane, thanks for this and your other post (which I cannot find at the moment) with your review of the book.

Lane Simonian

Thank you, fesk.  Here is a link to the discussion of the book.

https://www.alzconnected.org/discussion.aspx?g=posts&t=2147561612

​fesk

Thanks!

​fesk

I've been mainly using a diffuser and only consistently with lavender/orange at night. Now, based on the above, I think I'll try direct inhalation for the another oil (sage, etc.) and keep the diffuser routine. I don't know why, but I've been reluctant to try direct inhalation.

Lane Simonian

Very good, fesk.  Direct inhalation should work better for cognition.  Allergic reactions are possible but rare.  Otherwise, short-term exposure to essential oils via direct inhalation aromatherapy presents little risk.  

LittleVolcano

Thanks for the reminder, Lane! I've been meaning to try aromatherapy with Mom. Luckily, I already have a lot of them in my medicine cabinet. Won't hurt to try. Fingers crossed.

Lane Simonian

Hopefully the aromatherapy will help your mother.  I think that it will.