Cognitive–behavioural therapy for anxiety in dementia: pilot randomised controlled trial

Spector, Aimee; Charlesworth, Georgina; King, Michael; Lattimer, Miles; Sadek, Susan A.; Marston, Louise; Rehill, Amritpal; Hoe, Juanita; Qazi, Afifa; Knapp, Martín; Orrell, Martin

doi:10.1192/bjp.bp.113.140087

Cited by 79 publications

(128 citation statements)

References 25 publications

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“…In these two studies, patients of the experimental group increased their cognition relatively more than the control group after intervention, both for the ADAS-Cog and the MMSE. Other studies showed no significant differences between the conditions with regard to cognition [34,35,45,46,49,51,55,57,58]. Studies that used other assessment tools to measure cognitive impairment showed also positive effects.…”

Section: Skills Training Trialsmentioning

confidence: 95%

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Cognitive Therapy for Dementia Patients: A Systematic Review

Carrión

Folkvord

Anastasiadou

et al. 2018

Dement Geriatr Cogn Disord

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Background: Cognitive therapy is a well-established intervention for treating elderly suffering from dementia. In particular, reality orientation and skills training seem to be effective interventions for reversing cognitive impairment among elderly, although findings are inconclusive. Therefore, a systematic update of the existing evidence of cognitive therapy for people suffering from dementia is needed. Aim: To review existing scientific evidence regarding the efficacy of cognitive therapies for elderly suffering from dementia. Methods: Studies were retrieved from several bibliographic databases (January 2009 to December 2017) with prespecified selection criteria, data extraction, and methodological quality assessment. Results: In total, 10 reality orientation, 25 skills training, and 12 mixed trials were identified as meeting the inclusion criteria and were systematically reviewed. Results from reality orientation trials showed minor effects for cognitive assessments, while skills training trials and mixed trials showed contradicting effects on cognition. Effects on other outcomes (e.g., daily functioning, depression, language) were limited or not found. Conclusions: Skills training trials and mixed trials seem to affect cognitive impairment in a positive way, although the results are inconclusive. Comparison between studies was difficult due to differences in form of intervention. Because findings are inconclusive, more structuralized and comparable randomized controlled trials are needed.

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Section: Skills Training Trialsmentioning

confidence: 95%

“…Most studies included elderly with mild cognitive impairments [35, 36, 41-43, 47, 49-51, 53, 55, 56], some studies included elderly at risk for dementia [38,52,58], some other studies patients with mild to moderate dementia [37,46,57], moderate to severe dementia [34,48], diagnosed with Alzheimer disease [39,40,44,45,48,51,54].…”

Section: Skills Training Trialsmentioning

confidence: 99%

Cognitive Therapy for Dementia Patients: A Systematic Review

Carrión

Folkvord

Anastasiadou

et al. 2018

Dement Geriatr Cogn Disord

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“…The methods and results of the trial are explained fully in previous papers (Spector et al, 2012, Spector et al, 2015. No differences were found between the treatment or control group on quality of relationship at either 15 weeks or 6 months post-baseline for either unadjusted or adjusted analyses, irrespective of perspective (carer or person with dementia).…”

Section: Methodsmentioning

confidence: 99%

“…Increasing the availability and use of interventions to target the causes of relationship stressors, such as CBT for anxiety in dementia (Spector et al, 2015), should be a clinical priority. The findings cannot tell us whether carers' perceptions of their relationship are more negative due to their low mood, or whether low mood leads to a worsening of relationships.…”

Section: Implications For Practicementioning

confidence: 99%

Factors influencing the person–carer relationship in people with anxiety and dementia

Spector

Orrell

Charlesworth

et al. 2015

Aging & Mental Health

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“…The use of cognitive behavioral therapy (CBT) has been mentioned as a potential strategy for dealing with mood and behavior issues in dementia [26,87]. In one RCT for anxiety in dementia, CBT was found to be feasible but there was no measureable impact on anxiety [88]. More investigation of this type of therapy is needed, including feasibility and efficacy in different types and severities of dementia.…”

Section: Behavioral Approachesmentioning

confidence: 99%

Non-pharmacological Management of Behavioral Symptoms in Frontotemporal and Other Dementias

Barton

Ketelle

Merrilees

et al. 2016

FOC

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Worldwide prevalence of dementia is predicted to double every 20 years. The most common cause in individuals over 65 is Alzheimer's disease (AD), but in those under 65, frontotemporal dementia (FTD) is as frequent. The physical and cognitive decline that characterizes these diseases is commonly accompanied by troublesome behavioral symptoms. These behavioral symptoms contribute to significant morbidity and mortality among both patients and caregivers. Medications have been largely ineffective in managing these symptoms and carry significant adverse effects. Non-pharmacological interventions have been recommended to precede the utilization of pharmacological treatments. This article reviews the research about these interventions with special attention to the variations by etiology, especially FTD. The authors offer recommendations for improving utilization of these strategies and future research recommendations.

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Cognitive–behavioural therapy for anxiety in dementia: pilot randomised controlled trial

Abstract: CBT was feasible (in terms of recruitment, acceptability and attrition) and effective. A fully powered RCT is now required.

Cited by 79 publications

References 25 publications

Cognitive Therapy for Dementia Patients: A Systematic Review

Cognitive Therapy for Dementia Patients: A Systematic Review

Factors influencing the person–carer relationship in people with anxiety and dementia

Non-pharmacological Management of Behavioral Symptoms in Frontotemporal and Other Dementias

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