Dementia Talking therapy could help beat depression
TALKING therapy may improve depression symptoms for people with dementia, providing hope for a group that typically does not benefit from antidepressants, new research suggests.
Dementia patients often feel anxiety and depression, but how to treat these symptoms has puzzled experts because medicines commonly used for the conditions might not work for people living with dementia, and might cause side-effects.
Researchers suggest the study is important because it is the first review showing that psychological interventions – talking therapies – are effective and worthwhile in the context of ineffective drugs for depression in dementia.
Led by UCL researchers, it also indicates the therapies might additionally help to improve patient quality of life and everyday function.
The researchers are calling for clinical guidelines for dementia to be changed to recommend psychological therapies and, specifically, cognitive behavioural therapy.
They argue that their findings challenge the notion that psychological treatments are not worthwhile for people living with cognitive impairment and dementia.
Lead author, Dr Vasiliki Orgeta, associate professor at UCL Psychiatry, said: “We currently have no standard treatments for depression for people with dementia, as antidepressants do not work for them.
“Yet, despite the lack of supporting evidence, they are still prescribed for many people living with dementia, which is an important problem given that more and more evidence is accumulating suggesting that not only do they not improve symptoms, but they may increase risk of mortality.”
Dr Orgeta added: “Previous evidence into the clinical effectiveness of psychological treatments has been limited. Reporting on the most up-todate evidence, we found that these treatments, and specifically those focusing around supporting people with dementia to use strategies to reduce distress and improve wellbeing, are effective in reducing symptoms of depression.”
Psychological treatments, sometimes known as talking therapies, are based on psychological theories.
They involve a therapist working with an individual or a small group of people to develop skills and strategies to improve wellbeing, and these treatments can be adapted for people with cognitive impairment.
Researchers say people with dementia are twice as likely as others their age to be diagnosed with a major depressive disorder.
Depression and anxiety can also increase the severity of the neurological impairment itself, thus reducing independence and increasing the risk of entering long-term care.
Dr Orgeta added: “Our findings break the stigma that psychological treatments are not worthwhile for people living with cognitive impairment and dementia, and show that we need to invest in more research in this area and work towards increasing access to psychological services for people with dementia across the globe.
“We want people who experience cognitive impairment and dementia to have the same access to mental health treatments as everyone else.”
The paper, published by the Cochrane Library as part of its database of systematic reviews, used evidence from 29 trials of psychological treatments for people with dementia or mild cognitive impairment, including close to 2,600 study participants in total.