The Effects of Essential Oil and Massage on Patients’ Affected by Alzheimer’s Disease. An Observational Study


  • Antonio Bonacaro Department of Nursing, University of Suffolk, Ipswich IP4 1QJ, United Kingdom
  • Ivan Rubbi School of Nursing, University of Bologna, 40126 Bologna BO, Italy
  • Carmela Triglia Orthopedics Ward, Ferrara Hospital, 44122 - Ferrara, Italy
  • Valeria Cremonini Villa Maria Private Hospital, 48033 Cotignola RA, Italy
  • Alessia Conti Villa Maria Private Hospital, 48033 Cotignola RA, Italy
  • Sharon Brownie School of Nursing, University of Canberra, Canberra, BrSchool of Health Sciences, Swinburne University of Technology, Hawthorn, VIC 3122, Australia / School of Nursing, Griffith University, Nathan QLD 4111, Australia



Background: Alzheimer's Disease (AD) is the most widespread form of dementia. The present study analyses the effects of aromatherapy using Melissa Officinalis essential oil, applied by massage to the hands and forearms of patients suffering from Alzheimer's disease. and to evaluate the effect on their perceived overall quality of life.

Methods: A prospective observational study was conducted in two nursing homes in Italy in 2018. Data were collected through individual qualitative structured interviews based on the Quality of Life in Alzheimer’s Disease (QoL-AD) questionnaire and the Mini Mental State Examination (MMSE). The authors referred to STROBE guidelines for quality reporting of observational studies.

Results: Treatment with Melissa Officinalis showed positive effects on all patients after the 12th week of treatment. The results were most evident in patients in class 3 MMSE. However, class 4 MMSE patients also benefited from the treatment.

Conclusions: The aromatherapy treatment delivered in this observational study, using Melissa Officinalis essential oil applied to hands and forearms, showed an improvement in the quality of life of the patients living in two different nursing homes. Due to the small sample size in this study, it is suggested that more research be done on the effects and effectiveness of aromatherapy with Melissa Officinalis essential oil for Alzheimer's disease patients.


Quality Adjusted Life Years, Mental Status and Dementia Test, Alzheimer Disease, Aromatherapy, Essential Oil


Download data is not yet available.


Akhondzadeh, S., Noroozian, M., Mohammadi, M., Ohadinia, S., Jamshidi, A. H., & Khani, M. (2003). Melissa officinalis extract in the treatment of patients with mild to moderate Alzheimer's disease: a double blind, randomised, placebo controlled trial. Journal of Neurology, Neurosurgery, and Psychiatry, 74(7), 863–866.

Ballard, C. G., O'Brien, J. T., Reichelt, K., & Perry, E. K. (2002). 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. The Journal of Clinical Psychiatry, 63(7), 553–558.

Buckle, J. (2016). Clinical Aromatherapy: Essential Oils in Healthcare. 3rd Edition, Elsevier: Amsterdam, The Netherlands.

Butje, A. (2017). The Heart of Aromatherapy. An Easy-to-Use Guide for Essential Oils. Carlsbad, CA: Hay House Inc. California, United States.

Burns, A., Perry, E., Holmes, C., Francis, P., Morris, J., Howes, M. J., Chazot, P., Lees, G., & Ballard, C. (2011). A double-blind placebo-controlled randomized trial of Melissa officinalis oil and donepezil for the treatment of agitation in Alzheimer's disease. Dementia and Geriatric Cognitive Disorders, 31(2), 158–164.

Clarke, S. (2008). Handling, safety and practical applications for use of essential oils. Essential Chemistry for Aromatherapy, 2nd edition., Churchill Livingstone: Edinburgh, Scotland, 231- 64.

Cook, N., Lynch, J. (2008). Aromatherapy: reviewing evidence for its mechanisms of action and CNS effects. British Journal of Neuroscience Nursing, 4, 595-601.

Cooke, M., Moyle, W., Shum, D., Harrison, S., & Murfield, J. (2010). A randomized controlled trial exploring the effect of music on quality of life and depression in older people with dementia. Journal of Health Psychology, 15(5), 765–776.

Folstein, M. F., Folstein, S. E., & McHugh, P. R. (1975). "Mini-mental state". A practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12(3), 189–198. (2022). Deterioramento cognitivo (disturbi della memoria, demenze): i servizi e le risorse | Servizi e Sportelli Sociali | Rete civica Iperbole [cited 15 March 2022]. (2022). Le Principali Cause di Morte in Italia [cited 15 March 2022].

Kertapati, Y., Junaiti Sahar, Nursasi, A. Y., & Mutyah, D. (2022). The Effect of Chair Yoga with Spiritual Intervention on the Life Satisfaction of Older Adults. The Malaysian Journal of Nursing (MJN), 14(2).

Li, D., Li, Y., Bai, X., Wang, M., Yan, J., & Cao, Y. (2022). The Effects of Aromatherapy on Anxiety and Depression in People With Cancer: A Systematic Review and Meta Analysis. Frontiers in Public Health, 10, 853056.

Lim, C. K., Ching, C. W., Jun, L. J., & Yun, L. (2021). Level Of Knowledge And Attitude On Dementia Care Among Nurses. The Malaysian Journal of Nursing (MJN), 13(2), 3-7.

Logsdon, R.G., Gibbons, L.E., McCurry, S.M., Teri, L. (1999). Quality of life in Alzheimer's disease: patient and caregiver reports. Journal of Mental Health and Aging, 5, 21-32.

Logsdon, R. G., Gibbons, L. E., McCurry, S. M., & Teri, L. (2002). Assessing quality of life in older adults with cognitive impairment. Psychosomatic Medicine, 64(3), 510–519.

Meier, M., Unternaehrer, E., Dimitroff, S. J., Benz, A. B. E., Bentele, U. U., Schorpp, S. M., Wenzel, M., & Pruessner, J. C. (2020). Standardized massage interventions as protocols for the induction of psychophysiological relaxation in the laboratory: a block randomized, controlled trial. Scientific Reports, 10(1), 14774.

Maggio, A., Rosselli, S., & Bruno, M. (2016). Essential Oils and Pure Volatile Compounds as Potential Drugs in Alzheimer's Disease Therapy: An Updated Review of the Literature. Current Pharmaceutical Design, 22(26), 4011–4027.

Nunnally J. C., & Bernstein I. H. (2010). Psychometric Theory (3. ed. internat. stud. ed. [Nachdr.]). Tata McGraw-Hill Ed.

Nascimento, J.C., Gonçalves, V.S.S., Souza, B.R.S., Nascimento, L.C., Carvalho, B.M.R., Ziegelmann, P.K., Goes, T.C., & Guimar˜aes, A.G. (2022). New approaches to the effectiveness of inhalation aromatherapy in controlling painful conditions: A systematic review with meta-analysis. Complementary Therapies in Clinical Practice, 49, 101628. https://doi:org/10.1016/j.ctcp.2022.101628

Prince M, Comas-Herrera A, Knapp M, Guerchet M, Karagiannidou M. (2016). World Alzheimer report 2016. Improving healthcare for people living with dementia. Coverage, quality and costs now and in the future. Alzheimer's Disease International. World Alzheimer's Report.

Rubbi, I., Magnani, D., Naldoni, G., Di Lorenzo, R., Cremonini, V., Capucci, P., Artioli, G., Ferri, P. (2016). Efficacy of video-music therapy on quality-of-life improvement in a group of patients with Alzheimer’s disease: a pre-post study. Acta Biomed for Health Professions, 87, S4, 30-37

Snow, L. A., Hovanec, L., & Brandt, J. (2004). A controlled trial of aromatherapy for agitation in nursing home patients with dementia. Journal of Alternative and Complementary Medicine (New York, N.Y.), 10(3), 431– 437.

Steele, C., Rovner, B., Chase, G. A., & Folstein, M. (1990). Psychiatric symptoms and nursing home placement of patients with Alzheimer's disease. The American Journal of Psychiatry, 147(8), 1049–1051.

Sustrami, D., Suhardiningsih, A. S., Purbasari, D. N., & Budiarti, A. (2022). A Descriptive Study of Quality of Life of Caregiver in the Family of Schizophrenia Patients. The Malaysian Journal of Nursing (MJN), 14(2), 124-127.

Tabish S. A. (2008). Complementary and Alternative Healthcare: Is it Evidence-based?. International Journal of Health Sciences, 2(1), V–IX.

van der Watt, G., Laugharne, J., & Janca, A. (2008). Complementary and alternative medicine in the treatment of anxiety and depression. Current Opinion in Psychiatry, 21(1), 37–42.

von Elm, E., Altman, D. G., Egger, M., Pocock, S. J., Gøtzsche, P. C., Vandenbroucke, J. P., & STROBE Initiative (2007). The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. Lancet (London, England), 370(9596), 1453–1457.

Watson, K., Hatcher, D., & Good, A. (2019). A randomised controlled trial of Lavender (Lavandula Angustifolia) and Lemon Balm (Melissa Officinalis) essential oils for the treatment of agitated behaviour in older people with and without dementia. Complementary Therapies in Medicine, 42, 366–373.

Wilkinson, S. M., Love, S. B., Westcombe, A. M., Gambles, M. A., Burgess, C. C., Cargill, A., Young, T., Maher, E. J., & Ramirez, A. J. (2007). Effectiveness of aromatherapy massage in the management of anxiety and depression in patients with cancer: a multicenter randomized controlled trial. Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology, 25(5), 532–539.

Wimo, A., Guerchet, M., Ali, G. C., Wu, Y. T., Prina, A. M., Winblad, B., Jönsson, L., Liu, Z., & Prince, M. (2017). The worldwide costs of dementia 2015 and comparisons with 2010. Alzheimer's & Dementia : The Journal of the Alzheimer's Association, 13(1), 1–7.

World Health Organization. (2013). WHO traditional medicine strategy: 2014-2023. World Health Organization

Yang, Y. P., Wang, C. J., & Wang, J. J. (2016). Effect of Aromatherapy Massage on Agitation and Depressive Mood in Individuals With Dementia. Journal of Gerontological Nursing, 42(9), 38–46.

Y Ng, J., Nazir, Z., Nault, H. (2020). Complementary and alternative medicine recommendations for depression: a systematic review and assessment of clinical practice guidelines. BMC Complementary Medicine and Therapies, 20(1), 299.

Yuliastuti, C., Astuti, N. M. ., Winarno, D. D. ., Sari, M. A., & John, N. (2022). Family Support Related to Quality of Life in Diabetes Mellitus Patients with Ulcer. The Malaysian Journal of Nursing (MJN), 14(2).

Zhang, Q., Sharan, A., Espinosa, S. A., Gallego-Perez, D., & Weeks, J. (2019). The Path Toward Integration of Traditional and Complementary Medicine into Health Systems Globally: The World Health Organization Report on the Implementation of the 2014-2023 Strategy. Journal of Alternative and Complementary Medicine (New York, N.Y.), 25(9), 869–871.



How to Cite

Bonacaro, A., Rubbi, I., Triglia, C., Cremonini, V., Conti, A., & Brownie, S. . (2023). The Effects of Essential Oil and Massage on Patients’ Affected by Alzheimer’s Disease. An Observational Study. The Malaysian Journal of Nursing (MJN), 14(3), 116-125.