Talk Therapy Could Alleviate Depression, Improve Quality of Life for Individuals with Dementia

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

Psychological interventions, such as therapy, could be effective and worthwhile for individuals with dementia who have depression, according to a new study.

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

“We currently have no standard treatments for depression for people with dementia, as antidepressants do not work for them,” said lead author Vasiliki Orgeta, PhD, in a press release. “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 do not improve symptoms, but they may increase 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 drugs for depression in dementia. The review also shows that these interventions may provide additional benefits in terms of improving patient quality of life and everyday function. Based on these findings, the researchers are calling for clinical guidelines for dementia to be revised to recommend psychological therapies, specifically cognitive behavioral therapy (CBT).

Individuals with dementia are twice as likely as other people their age to be diagnosed with a major depressive disorder, according to the study. Studies have estimated that 16% of people with dementia experience depression, but this may 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, thus reducing independence and increasing the risk of entering long-term care.

“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 toward increasing access to psychological services for people with dementia across the globe,” Orgeta said in the press release. “We want people who experience cognitive impairment and dementia to have the same access to mental health treatments as everyone else.”

The paper incorporated evidence from 29 trials of psychological treatments for people with dementia or mild cognitive impairment, including nearly 2600 study participants in total. The psychological interventions varied somewhat, including CBT and supportive and counseling interventions, but were generally intended to support wellbeing, reduce distress, and improve coping.

The review found that psychological treatments for individuals with dementia may improve not only depressive symptoms, but also several other outcomes, such as quality of life and the ability to carry out everyday activities. Although more research is needed, these treatments may also improve depression remission. The authors added that the potential of improving many outcomes with one psychological intervention may be highly cost effective and could be a key to improving quality of life and wellbeing for individuals with dementia.

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

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

REFERENCE

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