Complementary medicine/alternative therapies

Summary

A large number of people with dementia and their carers use complementary therapies.

There needs to be more research into all types of treatment for dementia, including the effects of complementary therapies and treatments.

Individuals should seek advice from specially trained practitioners and their GP before using complementary therapies.

Background

The term complementary and alternative therapy covers many therapies. These include herbal medicine, aromatherapy and massage, music, dance and other psychosocial therapies, acupuncture and dietary supplements.

A large number of people with dementia and their carers use complementary or alternative health remedies. To date, there is not a great deal of high quality research into the treatment of dementia with complementary and alternative medicine, although there are some small but rigorous studies looking at aromatherapy, music therapy and dietary supplements. As with any health intervention, a specially trained practitioner and a doctor's advice should always be sought.

Dietary supplements

Currently, there are a number of dietary supplements being investigated for their impact on the development and progression of dementia including:

• Vitamin E
• Ginkgo biloba
• Folic acid

Many of these supplements have antioxidant effects, for which there is growing evidence of effectiveness in helping to prevent the development of Alzheimer's disease. However, Cochrane reviews of all three supplements found no evidence of efficacy in the treatment of people with Alzheimer's disease or other dementias (A Cochrane review is a systemic up to date summary of reliable evidence of the benefits and risks of healthcare intervention).

Complementary therapies

Some people with dementia and their carers have also gained benefit from complementary therapies including homeopathy, acupuncture, massage, aromatherapy and naturopathy (the use of natural therapies to enhance the body's innate ability to heal itself). Carers in particular have found complementary therapies particularly beneficial in reducing their own levels of stress.

Aromotherapy

Studies have compared aromatherapy with either lavender or lemon balm with a dummy treatment for symptoms of agitation in people with dementia, all showing significant benefit on agitation from using aromatherapy (Ballard, 2002).

However Alzheimer's Society has recently completed a larger study investigating the effects of the aromatherapy Melissa compared to placebo on agitation. Initial analysis of the data indicates that this had no effect on levels of agitation. A study funded by Alzheimer's Society looking at the impact of ginkgo biloba found it neither slows progression nor has significant impact on cognitive function or quality of life (McCarney et al, 2008).

Massage, bright light and music therapy

There is some evidence that massage and touch can improve some symptoms of dementia, such as agitation. However, only a very few studies have been carried out and more research is needed to provide definitive evidence (Viggo Hansen , Jørgensen and Ørtenblad L, 2006).

There are several studies comparing bright light therapy suggesting that this can be helpful and may reduce the agitation (Burns et al, 2002). Bright light therapy is a technique effective in treating seasonal affective disorder which involves use of high intensity light from a light box.

There is some evidence to suggest music therapy can improve symptoms of dementia. A recent project compared a number of psychosocial interventions, including music and found that they all improved aggressive symptoms to some extent, but social contact was more effective than music (Ballard et al Am J Geriatric Psych (2009) 17(9): 726). The potential benefit of music therapy is also highlighted in the National Dementia Strategy for England (NDSE). The Society offers a Singing for the brain service in an increasing number of areas.

The Society campaigns for:

• More research into all types of treatments for dementia, including complementary and alternative medicine

• Further evaluation of the effectiveness, safety and cost of complementary therapies in a similar way to conventional treatments.

• People with dementia and carers to be signposted to accurate information and guidance on using complementary and alternative therapies.

Further information

Birks J, Grimley Evans J, Van Dongen M, 2003, Ginkgo Biloba for Cognitive Impairment and Dementia (Cochrane Review), The Cochrane Library, Issue 4. Chichester , UK : John Wiley & Sons, Ltd.

Alzheimer's Society Factsheet, 2003, Complementary and alternative medicine and dementia, London

Burns A et al, 2002, Sensory stimulation in dementia. BMJ 325(7376):1312-3

Viggo Hansen N, Jørgensen T, Ørtenblad L, 2006, Massage and touch for dementia. Cochrane Database of Systematic Reviews, Issue 4.

Malouf R, Grimley Evans J, Areosa Sastre A, 2003, Folic acid with or without vitamin B12 for cognition and dementia. Cochrane Database of Systematic Reviews, Issue 4.

Birks J, Grimley Evans J, Lee H, 2002, Ginkgo biloba for cognitive impairment and dementia. Cochrane Database of Systematic Reviews, Issue 4.

Isaac M, Quinn R, Tabet N, 2000, Vitamin E for Alzheimer's disease and mild cognitive impairment. Cochrane Database of Systematic Reviews, Issue 4.

Ballard CG et al, 2002, Aromatherapy as a safe and effective treatment for the management of agitation in severe dementia: the results of a double-blind, placebo-controlled trial with Melissa, Journal of Clinical Psychiatry, 63: 553-558.

McCarney et al, 2008, Ginkgo biloba for mild to moderate dementia in a community setting: a pragmatic, randomised, parallel-group, double-blind, placebo-controlled trial. International Journal of Geriatric Psychiatry, Vol 23, Issue 12, 1222-1230.

Last updated: May 2010 by Chris Quince