combinations, including massage, message AND aromatherapy, dementia, agitation, stress, and anxiety. Setting • The study was performed in China-Japan Union Hospital of Jilin University (Changchun, China). Results • The employment of massage therapy, either alone or in combination with aromatherapy or calming music, can significantly decrease agitation, aggression, stress, and anxiety in patients with dementia. Moreover, massage therapy can also be beneficial for nursing personnel involved in taking care of patients with dementia. The combination of massage with aromatherapy seems to impart the most significant results in patients with dementia. Conclusion • Massage therapy may be a useful nonpharmacological intervention in nursing profession to control agitation and stress in patients with dementia. (Altern Ther Health Med. 2020;26(6):29-33) Hui Zhao, MA, is the nurse in charge, Department of Pediatrics, Second Hospital of Jilin University, in Changchun, China. Weiwei Gu, MA, is the nurse in charge, and Min Zhang, BA, bachelor, nurse in charge, in the Department of Hepatobiliary and Pancreatic Surgery, China-Japan Union Hospital of Jilin University, Changchun, China. Corresponding author: Min Zhang, MA E-mail address: minzhang163@yahoo.com INTRODUCTION The development of agitation, anxiety, and stress in individuals with Alzheimer’s disease is common and generally accounts for their restlessness, which is characterized by a constant need to move around in the form of wandering.1 These behavioral alterations pose a significant challenge to health care practitioners in their care of such patients. The various drugs to control agitation and associated behavioral symptoms include antipsychotics, sedatives, hypnotics, and anxiolytics. However, the employment of these drugs in addition to conventional drug therapy to combat memory disorders can lead to undesirable drug-drug interactions or development of adverse effects, including motor impairment—with antipsychotics—and sedation—with sedatives or anxiolytics.2,3 Therefore, exploring the usefulness of alternative nonpharmacological therapies to control behavioral abnormalities in patients with dementia has increased. Another essential feature of dementia is a significant decline in patients’ cognitive abilities, and communicating with patients through language becomes virtually ineffective. Scientists have examined techniques to maintain communication with patients with dementia at a basic level, such as through gentle touch in the form of massage.4 Some studies have shown the utility of massage and touch as a nonpharmacological alternative for controlling or managing anxiety, agitation, and stress in patients with dementia.5,6,7 This article is protected by copyright. To share or copy this article, please visit copyright.com. Use ISSN#1078-6791. To subscribe, visit alternative-therapies.com 30 ALTERNATIVE THERAPIES, NOV/DEC 2020 VOL. 26 NO. 6 Zhao—Massage Rherapy and Agitation in Patients With Dementia study were included. In total, 23 studies were found describing the influence of massage therapy either alone or in combination with other nonpharmacological interventions on agitation, stress, and anxiety in patients with dementia. Results Table 1 summarizes the results of the literature review. Behavioral Changes Reducing Agitation. Studies have shown the positive influence of massage therapy in controlling agitation and reducing behavioral problems in patients with dementia. Snyder et al’s studies evaluated the massage methods to control agitation in patients with dementia.8,9 The researchers employed 2 methods: hand massage and therapeutic touch. They found that hand massage can control agitation and was superior to therapeutic touch. The present review intended to examine the role of massage therapy, either alone or in conjunction with other nonpharmacological interventions such as aromatherapy or calming music, in attenuating aggression and related behavioral disorders in patients with dementia. Methods Procedures The research team searched the PubMed database, using different keyword combinations, including massage, message AND aromatherapy, dementia, agitation, stress, and anxiety. The purpose was to include all those studies documenting the positive or negative role of massage therapy either alone or in combination with other nonpharmacological interventions in altering agitation and stress in patients with dementia. All types of studies, including case reports, case studies, and randomized controlled trials pertaining to objective of this Table 1. Efficacy of Massage Therapy in Reducing Agitationa References Interventions Comments Snyder et al8 (2005); Snyder et al9 (1999) Hand massage and therapeutic touch • Effective in controlling agitation • Higher efficacy of hand massage Malaquin-Pavan10 (1997) Touch massage • Decrease in wandering, restlessness, and shouting • Increase in physical relaxation and sleepiness and better communication Kilstoff & Chenoweth5 (1998); Sansone & Schmitt6 (2000) Gentle massage on hands • Development of positive relationship between patient and caretaker • Decrease in agitation, distress, withdrawal, and wandering • More alertness and better sleep Moyle et al7 (2011) Foot massage • Decrease in agitation