As memory clinics move out from academic centres into mainstream clinical services, there is potential for greater co-ordination of their activities, and the development of an agreed core data set for assessment that would be valuable in the national monitoring of new anti-dementia treatments in clinical practice.

Sources of research fundingThere was no external funding for this study. It was supported through the facilities and staffing of the Leicestershire Partnership NHS Trust and the University of Leicester. Key points• Both Snoezelen and Reminiscence appear to have some short-term beneficial effect on mood and behaviour, with considerable variation between individual subjects.• This study did not demonstrate any significant differences between the interventions in terms of impact on subjects' behaviour. 1 A COMPARISON OF THE EFFECTS OF SNOEZELEN AND REMINISCENCE THERAPY ON THE AGITATED BEHAVIOUR OF PATIENTS WITH DEMENTIA AbstractBackground -Behavioural disturbance, such as agitation, is a common feature of dementia,

Multi-sensory therapy is an activity which usually takes place in a dedicated room where patients experience a range of unpatterned visual, auditory, olfactory and tactile stimuli (Baker et al, 1997). These rooms are designed to create a feeling of comfort and safety, where the individual can relax, explore and enjoy the surroundings (Fig 1.).

The endocannabinoid system (ECS) is now recognised as an important modulator of various central nervous system processes. More recently, an increasing body of evidence has accumulated to suggest antioxidant, anti-inflammatory and neuroprotective roles of ECS. In this review we discuss the role and therapeutic potential of ECS in neurodegenerative disorders such as Alzheimer's disease (AD), Parkinson's disease, multiple sclerosis, Huntington's disease, Tourette's syndrome, brain ischemia and amyotrophic lateral sclerosis (ALS). Elements of the ECS, such as fatty acid amide hydrolase or the cannabinoid receptors are now considered as promising pharmacological targets for some diseases. Although still preliminary, recent reports suggest that modulation of the ECS may constitute a novel approach for the treatment of AD. There are windows of opportunity in conditions caused by acute events such as trauma and ischemia as well in conditions that may involve altered functionality of the target receptors of the ECS, such as in AD. The ECS changes in Parkinson's disease could be compensatory as well as pathogenic of the illness process and needs further understanding and clinical studies are still in the preliminary stage. There is not enough evidence to support use of cannabinoids in treating Huntington's disease, tics and obsessive compulsive behaviour in Tourette's syndrome. Evidence on therapeutic use of cannabinoids in multiple sclerosis and ALS is currently limited. A major challenge for future research is the development of novel compounds with more selectivity for various components of the ECS which could target different neurotoxic pathways and be used in combination therapy.

Recent interest in the use of Snoezelen as an intervention for agitated behaviour in dementia remains supported by limited evidence of efficacy. This pilot study aimed to develop an approach for assessing the effects of Snoezelen on agitated behaviour in patients with dementia and its comparability to an existing reference intervention. Ten subjects with dementia were randomised to receive a four week course of either Snoezelen or reminiscence therapy. Therapeutic effects were assessed using an agitated behavioural mapping instrument (ABMI), the Cohen-Mansfield Agitation Inventory (CMAI) and by heart rate recording.Differences in dementia severity between the two groups hindered direct comparison of outcomes. Both interventions were well tolerated and the majority of both Snoezelen and reminiscence sessions were rated positively. ABMI ratings suggested that Snoezelen might reduce agitated behaviour during and immediately after the session but that this effect is short-lived. CMAI scores indicated reduced agitated behaviour during the intervention period. Heart rate data showed both decreases and increases during the sessions for different subjects. With minor modifications, the measures used will be appropriate for a full-scale comparative trial. Both interventions may have helpful short-term effects and whilst for some subjects the sessions are primarily relaxing, for others, they may have a more stimulating effect.