Shiatsu as an adjuvant therapy for depression in patients with Alzheimer's It disease: A pilot study

Objectives: Among the complementary and alternative medicine, Shiatsu might represent a feasible option for depression in Alzheimer's disease (AD). We evaluated Shiatsu on mood, cognition, and functional independence in patients undergoing physical activity. Design: Single-blind randomized controlled study. Setting Dedicated Community Center for patients with AD. Interventions: AD patients with depression were randomly assigned to the active group (Shiatsu + physical activity) or the control group (physical activity alone). Shiatsu was performed by the same therapist once a week for ten months. Main outcome measures: Global cognitive functioning (Mini Mental State Examination - MMSE), depressive symptoms (Geriatric Depression Scale - GDS), and functional status (Activity of Daily Living - ADL, Instrumental ADL - IADL) were assessed before and after the intervention. Results: We found a within-group improvement of MMSE, ADL, and GDS in the active group. However, the analysis of differences before and after the interventions showed a statistically significant decrease of GDS score only in the active group. Conclusions: The combination of Shiatsu and physical activity improved depression in AD patients compared to physical activity alone. The pathomechanism might involve neuroendocrine-mediated effects of Shiatsu on neural circuits implicated in mood and affect regulation.