Therapy for alzheimer's disease.

Dietary supplements
Good diet is essential for health. The use of vitamins and other supplements is often considered CAM even though it may not technically be so.

Antioxidants
There is growing evidence demonstrating the effectiveness of these compounds, which are found naturally in fruit and vegetables, in preventing the development of Alzheimer's disease. Reviews of the existing work in this area have been done and several antioxidants have shown positive effects: in particular, vitamin E, selegiline and idebenone.

One study examined vitamin E (2,000 units daily), selegiline (10mg daily) and a combination of the two in Alzheimer's disease, for a two-year period. The results were positive, although there is some controversy over the way they were reported. There seemed to be fewer falls in the group taking vitamin E. The authors recommend replication of the study to confirm their positive results. A large study investigating the possible prevention of dementia in patients with mild memory problems by taking vitamin E daily is currently underway. A study of idebenone found it to have a positive effect in Alzheimer's disease, with a dose-dependent effect (a better effect with a greater dose). It was also found to be safe. Positive effect and safety remained good after two years on the supplement.

General nutrition
Weight loss in patients with Alzheimer's disease is a recognised problem. It seems to be due to lack of attention to proper nourishment rather than part of the disease process. Dietary supplementation can produce a significant increase in body weight amongst patients with dementia, as found in patients on a hospital ward. Nutritional awareness is important for elderly people in general: one study of 96 healthy individuals aged 65 or over found that dietary supplementation of vitamins and trace elements improved mental function.

Aromatherapy and Massage (treating dementia).

Aromatherapy is the therapeutic use of essential oils derived from plants. The oils are generally:

•Applied directly to the skin, often accompanied by massage
•Heated in an oil burner to produce a pleasant odour
•Placed in a bath.
The oils are concentrated and should be used according to instructions - they should be diluted before being applied to the skin, for example.

Research funded by the Mental Health Foundation in 2000 highlighted the potential benefits of aromatherapy, specifically the use of melissa officinalis, or lemon balm, in the treatment of Alzheimer's disease. Researchers at Newcastle University's Medicinal Plant Research Centre believe that lemon balm may help prevent the loss of the key brain chemical acetylcholine. The loss of this chemical is one of the changes associated with Alzheimer's. Lemon balm may then work in the same way as the first generation of drugs for Alzheimer's disease, Aricept and Exelon.

This research suggests that aromatherapy may have a more specific role in the treatment of Alzheimer's than aiding relaxation. It highlights the need for further research.

In 2002, a paper by Alistair Burns in the British Medical Journal added weight to the potential benefits of aromatherapy for people with dementia, used as an alternative to neuroleptic drugs.

There are many different types and schools of massage in existence, but common to them all is the tactile manipulation of the body's soft tissue using the direct contact of the practitioner.

There is some evidence that aromatherapy - either alone or in combination with massage - is effective in helping people with dementia to relax. One trial compared aromatherapy and massage, aromatherapy and conversation, and massage only. It found that excessive 'wandering' could be reduced by aromatherapy and massage in combination.

Another study investigated lavender oil on a hospital ward, and showed a reduction in agitated behaviour. The benefits of aromatherapy and massage and expressive physical touch (which generally includes gentle massage) have also been reported, although one review of a number of studies reported inconclusive findings.