Non-Pharmacological Interventions for Depressive Symptoms in Dementia. A Cross-Over Rct.

Abstract

Background: Depression is accompanied by the early stages of Alzheimer’s disease (AD) and other forms of dementia. Depression can influence the daily functioning of the patients with dementia (PwD) and their cognitive abilities. Sometimes it is hard to diagnose because it may seem like apathy. The current pharmacological treatment can manage depressive symptoms, however the side effects of the drugs are severe. Methods: Sixty (60) PwD randomly assigned in six (6) different groups of 10 participants each. They received three non-pharmacological interventions: a) Reminiscence Therapy (RT), b) Body Exercise (BE) and c) Music Therapy (MT). The study is a cross-over randomized controlled trial including patients with different types of dementia and at different stages of dementia. The neuropsychological examination before the interventions included: MMSE, ACE-R, GDS, FRSSD and NPI Questionnaire (sub-questions only for depression). The interventions lasted for 5 days and there were 2 days off as a washout period. There was no drop-out rate. Results: The combination of MT (p=0.012)- BE (p=0.020)- RT (p=0.041) is the sequence of the interventions that can reduce depression. For the caregivers, we had the same combination with the best results as well: MT (p=0.002)- BE (p=0.006)- RT (p=0.012). Conclusions: There is a combination of non-pharmacological interventions that can reduce statistically significant the depression in patients with dementia (PwD) and their caregivers.