PT Mobile Logo

Search form


Nonconventional Treatments of Cognitive Impairment: Page 3 of 3

Nonconventional Treatments of Cognitive Impairment: Page 3 of 3

Possible adverse effects include skin allergies, phototoxic reactions, and potentiation of sedative-hypnotic medications when used with lavender or other oils known to have sedating effects. Pregnant women should exercise caution when considering aromatherapy because of possible effects on the fetus and uterus caused by systemic absorption of certain essential oils.

Electric current

The application of weak electric current to the head or neck may temporarily improve memory, behavior, and activities of daily living in patients with dementia.26,27 A Cochrane meta-analysis of 3 studies of transcranial electrical nerve stimulation devices used to treat dementia found evidence of significant but transient improvements in word recall, face recognition, and motivation immediately following treatment.28 Most research findings show that improvements are not sustained 6 weeks or more after treatment is terminated.


Music is used in many healing traditions to calm the mind and reduce agitated behavior. Findings of a meta-analysis evaluating studies of music therapy in persons with dementia show that various approaches--singing, dance, listening to music, and musical games--are associated with improvements in cognitive and behavioral functioning in persons with severe dementia, including reduced agitation, reduced wandering, enhanced social interaction, improved mood, reduced irritability and anxiety, increased cooperative behavior, and improved performance on standardized scales including the Mini-Mental State Examination.29

Regular music therapy was shown to reduce irritability and to improve expressive language in persons with dementia.30 Listening to binaural sounds in the beta frequency range (16 to 24 Hz) using headphones may enhance performance on tests of attention and short-term and immediate recall in healthy volunteers.31

Healing touch

Open studies, case reports, and one double-blind trial suggest that Healing Touch (HT) and Therapeutic Touch (TT) have beneficial effects on agitation in patients with dementia. In one small open study, measures of agitation were significantly improved in 14 residential patients with dementia who received 3 HT treatments weekly over a 4-week period.32 Diminished need for psychotropic medications was observed in 3 patients during the active treatment phase, and 2 residents required dose increases in the first 2 weeks after HT treatments were stopped.

In another small, sham-controlled study, 3 weekly 10- to 20-minute HT treatments were administered to patients with AD over a 5-week period. Patients who received regular HT treatments were found to have consistent reductions in disruptive behaviors and globally improved emotional and cognitive functioning, including enhanced socialization, a more regular sleep schedule, improved compliance with nursing home routines, greater emotional stability, and improved communication with staff. In a double-blind study (N = 57) that included mock TT in the control arm, agitated patients with dementia who received 2 brief TT treatments daily for 3 days exhibited significantly fewer behavioral symptoms of dementia, including reduced restlessness and fewer disruptive vocalizations, than patients who received mock TT.33

Dr Lake is in private practice in Monterey, Calif, and is an adjunct clinical instructor in the department of psychiatry and behavioral sciences at Stanford University in Stanford, Calif. He co-chairs the American Psychiatric Association Caucus on Complementary, Alternative, and Integrative Medicine (www.APACAM.org) and is author of the soon-to-be-published Textbook of Integrative Medical Health Care (Thieme).




1. Yabe T, Toriizuka K, Yamada H. Kami-untan-to (KUT) improves cholinergic deficits in aged rats. Phytomedicine. 1996;2:253-258.
2. Yabe T, Yamada H. Kami-untan-to enhances choline acetyl-transferase and nerve growth factor mRNA levels in brain cultured cells. Phytomedicine. 1996/1997;3: 361-367.
3. Arai H, Suzuki T, Sasaki H, et al. A new interventional strategy for Alzheimer's disease by Japanese herbal medicine [in Japanese]. Nippon Ronen Igakkai Zasshi. 2000;37:212-215.
4. Petkov VD, Stancheva SL, Tocuschieva L, Petkov VV. Changes in brain biogenic monoamines induced by the nootropic drugs adafenoxate and meclofenoxate and by citicholine (experiments on rats). Gen Pharmacol. 1990;21:71-75.
5. Spasov AA, Wikman GK, Mandrikov VB, et al. A double-blind, placebo-controlled pilot study of the stimulating and adaptogenic effect of Rhodiola rosea SHR-5 extract on the fatigue of students caused by stress during an examination period with a repeated low-dose regimen. Phytomedicine. 2000;7:85-89.
6. Pettegrew JW, Levine J, McClure RJ. Acetyl-l-carnitine physical-chemical, metabolic and therapeutic properties: relevance for its mode of action in Alzheimer's disease and geriatric depression. Mol Psychiatry. 2000;5:616-632.
7. Arrigo A, Casale R, Buonocore M, Ciano C. Effects of acetyl-l-carnitine on reaction times in patients with cerebrovascular insufficiency. Int J Clin Pharmacol Res. 1990;10:133-137.
8. Thal LJ, Carta A, Clarke WR, et al. A one-year multicenter placebo-controlled study of acetyl-l-carnitine in patients with Alzheimer's disease. Neurology. 1996;47:705-711.
9. Calvani M, Carta A, Caruso G, et al. Action of acetyl-l-carnitine in neurodegeneration and Alzheimer's disease. Ann N Y Acad Sci. 1992;663:483-486.
10. Hudson S, Tabet N. Acetyl-l-carnitine for dementia (Cochrane Review). In: The Cochrane Library, Issue 2. Chichester, UK: John Wiley & Sons, Ltd; 2004.
11. Passeri M, Cucinotta D, Abate G, et al. Oral 59-methyltetrahydrofolic acid in senile organic mental disorders with depression: results of a double-blind multi-center study. Aging (Milano). 1993;5:63-71.
12. Malouf R, Areosa Sastre A. Vitamin B12 for cognition (Cochrane Review). In: The Cochrane Library, Issue 2. Chichester, UK: John Wiley & Sons, Ltd; 2004.
13. Mimori Y, Katsuoka H, Nakamura S. Thiamine therapy in Alzheimer's disease. Metab Brain Dis. 1996;11: 89-94.
14. Martin DC, Francis J, Protetch J, Huff FJ. Time dependency of cognitive recovery with cobalamin replacement: report of a pilot study. J Am Geriatr Soc. 1992; 40:168-172.
15. Engelhart M, Geerlings M, Ruitenberg A, et al. Dietary intake of antioxidants and risk of Alzheimer's disease. JAMA. 2002;287:3223-3229.
16. Kalmijn S, Feskens EJ, Launer LJ, Kromhout D. Polyunsaturated fatty acids, antioxidants, and cognitive function in very old men. Am J Epidemiol. 1997; 145:33-41.
17. Jama JW, Launer LJ, Witteman JC, et al. Dietary antioxidants and cognitive function in a population-based sample of older persons. The Rotterdam study. Am J Epidemiol. 1996;144:275-280.
18. Tabet N, Birks J, Grimley E, et al. Vitamin E for Alzheimer's disease (Cochrane Review). In: The Cochrane Library, Issue 2. Chichester U.K: John Wiley & Sons, Ltd; 2004.
19. Zandi PP, Anthony JC, Khachaturian AS, et al. Reduced risk of Alzheimer disease in users of antioxidant vitamin supplements; the Cache County Study. Arch Neurol. 2004;61:82-88.
20. Friess E, Trachsel L, Guldner J, et al. DHEA administration increases rapid eye movement sleep and EEG power in the sigma frequency range. Am J Physiol. 1995;268(1 pt 1):E107-E113.
21. Huppert F, Van Niekerk J. Dehydroepiandrosterone (DHEA) supplementation for cognitive function (Cochrane Review). In: The Cochrane Library, Issue 2. Chichester, UK: John Wiley & Sons, Ltd; 2004.
22. Azuma T, Nagai Y, Saito T, et al. The effect of dehydroepiandrosterone sulfate administration to patients with multi-infarct dementia. J Neurol Sci. 1999;162(1): 69-73.
23. Thorgrimsen L, Spector A, Wiles A, Orrell M. Aroma therapy for dementia (Cochrane Review). In: The Cochrane Library, Issue 2. Chichester, UK: John Wiley & Sons, Ltd; 2004.
24. Holmes C, Hopkins V, Hensford C, et al. Lavender oil as a treatment for agitated behaviour in severe dementia: a placebo controlled study. Int J Geriatr Psychiatry. 2002;17:305-308.
25. Ballard CG, O'Brien JT, Reichelt K, Perry EK. 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. J Clin Psychiatry. 2002;63:553-558.
26. Van Someren EJ, Scherder EJ, Swaab DF. Transcutaneous electrical nerve stimulation (TENS) improves circadian rhythm disturbances in Alzheimer disease. Alzheimer Dis Assoc Disord. 1998;12:114-118.
27. Scherder EJ, Bouma A, Steen AM. Effects of short-term transcutaneous electrical nerve stimulation on memory and affective behaviour in patients with probable Alzheimer's disease. Behav Brain Res. 1995;67: 211-219.
28. Cameron M, Lonergan E, Lee H. Transcutaneous electrical nerve stimulation (TENS) for dementia (Cochrane Review). In: The Cochrane Library, Issue 2. Chichester UK: John Wiley & Sons, Ltd; 2004.
29. Koger SM, Chapin K, Brotons M. Is music therapy an effective intervention for dementia? A meta-analytic review of literature. J Music Ther. 1999;36:2-15.
30. Suzuki M, Kanamori M, Watanabe M, et al. Behavioral and endocrinological evaluation of music therapy for elderly patients with dementia. Nurs Health Sci. 2004;6:11-18.
31. Kennerly R. An empirical investigation into the effect of beta frequency binaural beat audio signals on four measures of human memory. Hemi-Sync J. 14:3; Summer 1996, i-iv.
32. Wang K, Hermann C. Healing Touch on agitation levels to dementia. Healing Touch Newsletter. 1999;9:3.
33. Woods DL, Craven RF, Whitney J. The effect of therapeutic touch on behavioral symptoms of persons with dementia. Altern Ther Health Med. 2005;11:66-74.

Loading comments...

By clicking Accept, you agree to become a member of the UBM Medica Community.