Non-drug therapy in dementia

Non-pharmacological approaches are first line for treating the distressing, non-cognitive symptoms of dementia (‘behavioural and psychological symptoms of dementia’ or BPSD) because they have a favourable balance of benefits and harms. Systematic reviews have concluded that individualised care is best.1,2 

While many trials of non-drug approaches have been of poor quality, a recent review of trials that met quality requirements found evidence of efficacy for several treatments.2

The authors concluded that aromatherapy, personalised music, video or audio tapes of family members, muscle relaxation therapy and changes to bathing routines significantly reduced BPSD.

A new trial has now found aromatherapy to be no better than placebo. Agitation improved significantly among trial participants over 12 weeks, regardless of whether they were assigned to placebo, donepezil, or aromatherapy. This divergent