Relaxation techniques decrease anxiety in dementia

Acupressure and Montessori-based activities decrease agitation in institutionalized residents with dementia, according to a report in The New England Journal of Medicine.

Nonpharmacological interventions such as acupuncture, Montessori methods, and massage have all been used to manage agitation and promote relaxation in patients with dementia, the authors explain. A number of studies have tested the effects of these approaches, but the studies had significant limitations.

Dr. Li-Chan Lin from National Yang-Ming University, Taipei, and colleagues explored the effectiveness of acupressure and Montessori-based activities in decreasing agitated behaviors of 133 institutionalized residents with dementia. This was compared with the potentially calming presence of a visitor who acted as a control. All participants underwent all three treatments in three different sequences.

Acupressure daily (6 days weekly) for 4 weeks significantly decreased overall agitated behaviors, the authors report, especially in the Cohen-Mansfield Agitation Inventory (CMAI) subcategories of physically nonaggressive and physically aggressive behaviors.

Montessori-based activities on the same schedule significantly improved aggressive behavior and physically nonaggressive behavior, the researchers note.

Although neither approach decreased verbally agitated behaviors, Montessori treatment was associated with a significant increase in positive affect.

Nurses' aides noted that ease of care improved when they assisted residents with eating, toileting, bathing, grooming, sleeping, walking, and various other activities after the acupressure or Montessori-based activities.

"This study confirms that a noninvasive, traditional Chinese medical procedure, acupressure, coupled with a Western activities program, could be useful in caring for people with dementia and that in-service training for formal caregivers in private and institutional settings would be beneficial," the investigators conclude.

SOURCE: The New England Journal of Medicine, July 2009.