Talk therapy may ease depression and improve quality of life for people with dementia

Studies have estimated that 16% of people with dementia suffer from depression, but this can be as high as 40%, demonstrating a great need for effective treatments.

Psychological interventions, such as therapy, may be effective and helpful for people with dementia who experience depression, according to a new study.

Feelings of anxiety and depression are common in people with dementia and mild cognitive impairment, but the best treatment for these symptoms is currently unknown. According to the study, drugs often used to treat these symptoms may not be effective in people with dementia and may in fact cause adverse effects in this patient population.

“We currently have no standard treatment for depression in people with dementia because antidepressants don’t work for them,” lead author Vasiliki Orgeta, PhD, said in a press release. “Yet, despite the lack of supporting evidence, they are still being prescribed to many people with dementia, which is a significant issue given that more and more evidence is accumulating to suggest that not only do they not do not improve symptoms, but may increase the risk of mortality.

New findings published in the Cochrane Review are the first review showing that psychological interventions are effective in the context of ineffective medications for depression in dementia. The review also shows that these interventions may provide additional benefits in terms of improving patients’ quality of life and daily functions. Based on these findings, the researchers call for clinical guidelines for dementia to be revised to recommend psychological therapies, especially cognitive behavioral therapy (CBT).

According to the study, people with dementia are twice as likely as other people their age to be diagnosed with major depressive disorder. Studies have estimated that 16% of people with dementia suffer from depression, but this can be as high as 40%, demonstrating a great need for effective treatments. Depression and anxiety can also increase the severity of the neurological impairment itself, thereby reducing independence and increasing the risk of entering long-term care.

“Our findings break the stigma that psychological treatments are not worth it for people with cognitive impairment and dementia and show that we need to invest more in research in this area and work to increase access to psychological services for people with dementia around the world,” Orgeta said in the press release. “We want people with cognitive impairment and dementia to have the same access to mental health treatment as everyone else.”

The article incorporated evidence from 29 trials of psychological treatments for people with dementia or mild cognitive impairment, including nearly 2,600 study participants in total. Psychological interventions varied somewhat, including CBT and support and counseling interventions, but were generally intended to support well-being, reduce distress, and improve coping.

The review found that psychological treatments for people with dementia can improve not only depressive symptoms, but also several other outcomes, such as quality of life and the ability to perform daily activities. Although more research is needed, these treatments may also improve depression remission. The authors added that the potential for improving many outcomes with a single psychological intervention can be very cost-effective and could be the key to improving the quality of life and well-being of people with dementia.

The authors judged the evidence to be of moderate quality overall, meaning that it is of high enough quality to warrant clinical recommendations to support the use of psychological therapies. Larger studies are also needed as they may be able to identify a more substantial effect, the authors say.

“There is now sufficient quality evidence to support the use of psychological treatments for people with dementia, rather than prescribing drugs, and without the risk of drug side effects,” said co-author Phuong Leung. , PhD, in the press release. “What we need now is for more clinicians to opt for talking therapies for their patients and commit to funding further high-quality research in this area.”

REFERENCE

Talk therapy can alleviate depression and improve quality of life for people with dementia. Press release. EurekAlert; April 25, 2022. Accessed May 11, 2022. https://www.eurekalert.org/news-releases/950562

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