Insufficient evidence to draw conclusions about the possibility that massage and touch interventions are effective for dementia or associated problems

Massage and touch interventions have been proposed as an alternative or supplement to pharmacological and other treatments to counteract anxiety, agitated behaviour, depression, and if possible to slow down cognitive decline in people with dementia. This review provides an overview of existing research on the use of massage for people with dementia. Eighteen studies of the effects of massage interventions were located, but only two small studies were of a sufficient methodological rigour to count as evidence to answer the question of effect.

The small amount of evidence currently available is in favour of massage and touch interventions, but is too limited in scope to allow for general conclusions. Further, high-quality randomized controlled trials are required.

Authors' conclusions: 

Massage and touch may serve as alternatives or complements to other therapies for the management of behavioural, emotional and perhaps other conditions associated with dementia. More research is needed, however, to provide definitive evidence about the benefits of these interventions.

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Background: 

Massage and touch have been suggested as a non-pharmacological alternative or supplement to other treatments offered in order to reduce or manage a range of conditions associated with dementia such as anxiety, agitated behaviour and depression. It has also been suggested that massage and touch may counteract cognitive decline.

Objectives: 

To assess the effects of a range of massage and touch therapies on conditions associated with dementia, such as anxiety, agitated behaviour and depression, identify any adverse effects, and provide recommendations about future trials.

Search strategy: 

We identified trials from a search of the Specialized Register of the Cochrane Dementia and Cognitive Improvement Group on 12 July 2005 using the terms massage, reflexology, touch and shiatsu. This Register contains records from all major healthcare databases and many ongoing trials databases and is updated regularly. In addition, general and specific literature databases were searched and patient and therapist organizations contacted.

Selection criteria: 

Randomized controlled trials (RCTs) in which a massage or touch intervention was given to persons suffering from dementia of any type, compared with other treatments or no treatment, and in which effect parameters included measures of behavioural problems, caregiver burden, emotional distress or cognitive abilities, were eligible for inclusion. Furthermore, we employed a set of minimal methodological quality criteria as a selection filter.

Data collection and analysis: 

We identified 34 references in the initial searches. Of these, seven were actual or possible RCTs, but only two were found to meet the requirements of the set of minimal methodological criteria.

Main results: 

The very limited amount of reliable evidence available is in favour of massage and touch interventions for problems associated with dementia. However, this evidence addresses only two specific applications: hand massage for the immediate or short-term reduction of agitated behaviour, and the addition of touch to verbal encouragement to eat for the normalization of nutritional intake. The existing evidence does not support general conclusions about the effect or possible side effects of such interventions. No severe side effects were identified.

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