Optimal nonpharmacological management of agitation in Alzheimer’s disease: challenges and solutions
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Optimal nonpharmacological management of agitation in Alzheimer’s disease: challenges and solutionsAutor(es)
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2016-02-22Cita bibliográfica
Millán-Calenti JC, Lorenzo-López L, Alonso-Búa B, de Labra C, González-Abraldes I, Maseda A. Optimal nonpharmacological management of agitation in Alzheimer's disease: challenges and solutions. Clin Interv Aging. 2016 Feb 22;11:175-84.
Resumo
[Abstract] 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.
Palabras chave
Dementia
Nonpharmacological
Behavioral and psychological symptoms
Nonpharmacological
Behavioral and psychological symptoms
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Creative Commons Attribution-NonCommercial 3.0 International License (CC-BY 3.0)