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Optimal nonpharmacological management of agitation in Alzheimer’s disease: challenges and solutions

Many patients with Alzheimer’s disease will develop agitation at later stages of the disease, which constitutes one of the most challenging and distressing aspects of dementia. Recently, nonpharmacological therapies have become increasingly popular and have been proven to be effective in managing th...

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Autores principales: Millán-Calenti, José Carlos, Lorenzo-López, Laura, Alonso-Búa, Begoña, de Labra, Carmen, González-Abraldes, Isabel, Maseda, Ana
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Dove Medical Press 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4769004/
https://www.ncbi.nlm.nih.gov/pubmed/26955265
http://dx.doi.org/10.2147/CIA.S69484
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author Millán-Calenti, José Carlos
Lorenzo-López, Laura
Alonso-Búa, Begoña
de Labra, Carmen
González-Abraldes, Isabel
Maseda, Ana
author_facet Millán-Calenti, José Carlos
Lorenzo-López, Laura
Alonso-Búa, Begoña
de Labra, Carmen
González-Abraldes, Isabel
Maseda, Ana
author_sort Millán-Calenti, José Carlos
collection PubMed
description Many patients with Alzheimer’s disease will develop agitation at later stages of the disease, which constitutes one of the most challenging and distressing aspects of dementia. Recently, nonpharmacological therapies have become increasingly popular and have been proven to be effective in managing the behavioral symptoms (including agitation) that are common in the middle or later stages of dementia. These therapies seem to be a good alternative to pharmacological treatment to avoid unpleasant side effects. We present a systematic review of randomized controlled trials (RCTs) focused on the nonpharmacological management of agitation in Alzheimer’s disease (AD) patients aged 65 years and above. Of the 754 studies found, eight met the inclusion criteria. This review suggests that music therapy is optimal for the management of agitation in institutionalized patients with moderately severe and severe AD, particularly when the intervention includes individualized and interactive music. Bright light therapy has little and possibly no clinically significant effects with respect to observational ratings of agitation but decreases caregiver ratings of physical and verbal agitation. Therapeutic touch is effective for reducing physical nonaggressive behaviors but is not superior to simulated therapeutic touch or usual care for reducing physically aggressive and verbally agitated behaviors. Melissa oil aromatherapy and behavioral management techniques are not superior to placebo or pharmacological therapies for managing agitation in AD. Further research in clinical trials is required to confirm the effectiveness and long-term effects of nonpharmacological interventions for managing agitation in AD. These types of studies may lead to the development of future intervention protocols to improve the well-being and daily functioning of these patients, thereby avoiding residential care placement.
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spelling pubmed-47690042016-03-07 Optimal nonpharmacological management of agitation in Alzheimer’s disease: challenges and solutions Millán-Calenti, José Carlos Lorenzo-López, Laura Alonso-Búa, Begoña de Labra, Carmen González-Abraldes, Isabel Maseda, Ana Clin Interv Aging Review Many patients with Alzheimer’s disease will develop agitation at later stages of the disease, which constitutes one of the most challenging and distressing aspects of dementia. Recently, nonpharmacological therapies have become increasingly popular and have been proven to be effective in managing the behavioral symptoms (including agitation) that are common in the middle or later stages of dementia. These therapies seem to be a good alternative to pharmacological treatment to avoid unpleasant side effects. We present a systematic review of randomized controlled trials (RCTs) focused on the nonpharmacological management of agitation in Alzheimer’s disease (AD) patients aged 65 years and above. Of the 754 studies found, eight met the inclusion criteria. This review suggests that music therapy is optimal for the management of agitation in institutionalized patients with moderately severe and severe AD, particularly when the intervention includes individualized and interactive music. Bright light therapy has little and possibly no clinically significant effects with respect to observational ratings of agitation but decreases caregiver ratings of physical and verbal agitation. Therapeutic touch is effective for reducing physical nonaggressive behaviors but is not superior to simulated therapeutic touch or usual care for reducing physically aggressive and verbally agitated behaviors. Melissa oil aromatherapy and behavioral management techniques are not superior to placebo or pharmacological therapies for managing agitation in AD. Further research in clinical trials is required to confirm the effectiveness and long-term effects of nonpharmacological interventions for managing agitation in AD. These types of studies may lead to the development of future intervention protocols to improve the well-being and daily functioning of these patients, thereby avoiding residential care placement. Dove Medical Press 2016-02-22 /pmc/articles/PMC4769004/ /pubmed/26955265 http://dx.doi.org/10.2147/CIA.S69484 Text en © 2016 Millán-Calenti et al. This work is published and licensed by Dove Medical Press Limited The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed.
spellingShingle Review
Millán-Calenti, José Carlos
Lorenzo-López, Laura
Alonso-Búa, Begoña
de Labra, Carmen
González-Abraldes, Isabel
Maseda, Ana
Optimal nonpharmacological management of agitation in Alzheimer’s disease: challenges and solutions
title Optimal nonpharmacological management of agitation in Alzheimer’s disease: challenges and solutions
title_full Optimal nonpharmacological management of agitation in Alzheimer’s disease: challenges and solutions
title_fullStr Optimal nonpharmacological management of agitation in Alzheimer’s disease: challenges and solutions
title_full_unstemmed Optimal nonpharmacological management of agitation in Alzheimer’s disease: challenges and solutions
title_short Optimal nonpharmacological management of agitation in Alzheimer’s disease: challenges and solutions
title_sort optimal nonpharmacological management of agitation in alzheimer’s disease: challenges and solutions
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4769004/
https://www.ncbi.nlm.nih.gov/pubmed/26955265
http://dx.doi.org/10.2147/CIA.S69484
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