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Using acupressure and Montessori-based activities to decrease agitation for residents with dementia: a cross-over trial

Contact Information


Li-Chan Lin,

acupressure; Montessori methods; agitation; long-term care facilities


OBJECTIVES: To explore the effectiveness of acupressure and Montessori-based activities in decreasing the agitated behaviors of residents with dementia. DESIGN: A double-blinded, randomized (two treatments and one control; three time periods) cross-over design was used. SETTING: Six special care units for residents with dementia in long-term care facilities in Taiwan were the sites for the study. PARTICIPANTS: One hundred thirty-three institutionalized residents with dementia. INTERVENTION: Subjects were randomized into three treatment sequences: acupressure-presence-Montessori methods, Montessori methods-acupressure-presence and presence-Montessori methods-acupressure. All treatments were done once a day, 6 days per week, for a 4-week period. MEASUREMENT: The Cohen-Mansfield Agitation Inventory, Ease-of-Care, and the Apparent Affect Rating Scale. RESULTS: After receiving the intervention, the acupressure and Montessori-based-activities groups saw a significant decrease in agitated behaviors, aggressive behaviors, and physically nonaggressive behaviors than the presence group. Additionally, the ease-of-care ratings for the acupressure and Montessori-based-activities groups were significantly better than for the presence group. In terms of apparent affect, positive affect in the Montessori-based-activities group was significantly better than in the presence group. CONCLUSION: This study confirms that a blending of traditional Chinese medicine and a Western activities program would be useful in elderly care and that in-service training for formal caregivers in the use of these interventions would be beneficial for patients.


Lin, L. C., Yang, M. H., Kao, C. C., Wu, S. C., Tang, S. H., & Lin, J. G. (2009). Using acupressure and Montessori-based activities to decrease agitation for residents with dementia: a cross-over trial. Journal of the American Geriatrics Society, 57(6), 1022–1029.





Conent Area

Li-Chan Lin

EWB-Related Construct

(3) Positive Affect

Study Design

Species or Study Population

(5) RCT

Sex (%Female)


Age (Mean, SD)

80.1, 8.1

Younger Controls?


Longitudinal Data?


Sample Size



acupressure and Montessori-based activities

Ethnicity (%white)

not stated (Taiwan)

Inclusion Criteria

(1) Being diagnosed with dementia by a physician and documented as such on the resident’s chart.
(2) Scoring 35 or above on the long form of the Cohen-Mansfield Agitation Inventory (CMAI) for institutional use.18
(3) Ability to stay in the institution during the study period.
(4) No broken skin, infection, or amputation found on the acupressure points selected for the study

Exclusion Criteria

not stated

EWB Measures

Apparent Affect Rating Scale

Non-EWB Behavioral

Cohen-Mansfield Agitation Inventory,

Physiological Measures


Brain IMaging Modality

Brain IMaging Paradigm


Brain Region/Circuit


Biological Measures


Other Neural Measures

Data Availability?


Data Avalability Details


Diagnostic Measures

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