Alzheimer's disease is the most common cause of dementia, affecting around 417,000 people in the UK alone. The term 'dementia' is used to describe the symptoms that occur when the brain is affected by specific diseases and conditions.

Alzheimer's disease, first described by the German neurologist Alois Alzheimer, is a physical disease affecting the brain. During the course of the disease, 'plaques' and 'tangles' develop in the structure of the brain, leading to the death of brain cells. People with Alzheimer's also have a shortage of some important chemicals in their brains. These chemicals are involved with the transmission of messages within the brain. Alzheimer's is a progressive disease, which means that gradually, over time, more parts of the brain are damaged. As this happens, the symptoms become more severe.

People in the early stages of Alzheimer's disease may experience lapses of memory and have problems finding the right words. As the disease progresses, they may:

• become confused, and frequently forget the names of people, places, appointments and recent events
• experience mood swings. They may feel sad or angry. They may feel scared and frustrated by their increasing memory loss
• become more withdrawn, due either to a loss of confidence or to communication problems.

As the disease progresses, people with Alzheimer's will need more support from those who care for them. Eventually, they will need help with all their daily activities. While there are some common symptoms of Alzheimer's disease, it is important to remember that everyone is unique. No two people are likely to experience Alzheimer's disease in the same way.

So far, no one single factor has been identified as a cause for Alzheimer's disease. It is likely that a combination of factors, including age, genetic inheritance, environmental factors, diet and overall general health, are responsible. In some people, the disease may develop silently for many years before symptoms appear and the onset of clinical disease may require a trigger.

Many people fear that they may inherit Alzheimer's disease, and scientists are currently investigating the genetic background to Alzheimer's. We do know that there are a few families where there is a very clear inheritance of the disease from one generation to the next. This is often in families where the disease appears relatively early in life. In the vast majority of cases, however, the effect of inheritance seems to be small. If a parent or other relative has Alzheimer's disease, your own chances of developing the disease are only a little higher than if there were no cases of Alzheimer's in the immediate family. However, carriers of the ApoE4 gene variant have a much higher chance of developing Alzheimer's disease.

The environmental factors that may contribute to the onset of Alzheimer's disease have yet to be identified. A few years ago, there were concerns that exposure to aluminium might cause Alzheimer's disease. However, these fears have largely been discounted. Because of the difference in their chromosomal make-up, people with Down's syndrome who live into their 50s and 60s may develop Alzheimer's disease.

People who have had severe head or whiplash injuries also appear to be at increased risk of developing dementia. Boxers who receive continual blows to the head are at risk too. Research has also shown that people who smoke, and those who have high blood pressure or high cholesterol levels, increase their risk of developing Alzheimer's.

There is currently no cure for Alzheimer's disease. However, some drug treatments are available that can ameliorate the symptoms or slow down the disease progression in some people.

People suffering from Alzheimer's disease and other forms of dementia often go through difficult stages as the disease progresses: depression, aggression, agitation, delusions, hallucinations, sleep disturbance, and wandering. These conditions are often treated with drugs to sedate or 'tranquilize' the patient, but the side effects they produce are quite often worse than their benefits. Excessive sedation leads to falls, and sometimes they may accelerate mental decline. Behavioral therapy is a better option, but it requires extensive involvement by health professionals, and may not always be readily available. It's not surprising then, that aromatherapy and 'alternative medicine' approaches have been tried for such patients.

We are not suggesting for one moment that Aromatherapy, Herbology or Essential oils and plants can cure Alzheimer’s disease, but like most ailments, they can certainly help alleviate some of the symptoms. Your first port of call if you think that you or a member of your family may be suffering from the disease is your doctor or healthcare professional.

Two treatments have proved quite successful recently in controlled clinical studies - aromatherapy and bright-light boxes. Two professors and two senior lecturers of old age psychiatry have recently reviewed the evidence in favor of these therapies in the British Medical Journal.

Aromatherapy

Three studies reported in the last two years show significant benefits of aromatherapy on agitation in advanced Alzheimer's; and there were no side effects. In the first study, 2% lavender oil was given by daily inhalation, while the second used the same therapy twice weekly. In the third, lemon or Melissa oil was used in a hand cream, twice daily. Almost all the severely demented patients completed the studies, which in itself is remarkable; in drug studies with a similar purpose there is usually a 30% drop-out rate. All three studies showed significant improvements in agitation scores.

One must remember that severely demented people have usually lost their sense of smell completely. This means the "aroma" effect doesn't work through the smell sensors in the nose. It's likely that substances called terpenes, which are present in essential oils, are absorbed through the lungs and find their way to the brain. Some terpines are reported to have 'cholinergic' effects, like those of the cholinergic drugs effective in Alzheimer's (donepezil, galantamine, and rivastigmine).

Bright-light treatment

Bright light boxes, which the patient must look at for a short period - 1/2 to 1 hour - each day, provide up to 30 times the amount of an average office light. This is an accepted treatment for the depression called the 'winter blues', otherwise known as seasonal affective disorder. Three controlled studies have been reported concerning its effect in seriously demented patients. There were many more drop-outs than with aromatherapy; 40% to 50% of the patients didn't complete their course of treatment.

Results, however, were positive. In one study, restlessness and unnecessary movement were reduced, sleep was improved in another, and mental ability test scores (mini-mental state examination) were increased in the third. Again, there were no side effects.

There is not enough research at present to suggest that these treatments should be put into daily practice for those suffering from Alheimer’s disease. However, the results are encouraging, and the lack of side effects should support further studies. The idea of sensory stimulation for demented patients is worth exploring. And it's interesting to speculate what aromatherapy may have to offer in other behavioral or psychiatric conditions.