Psychological treatments for depression and anxiety in dementia and mild cognitive impairment

Orgeta, Vasiliki; Qazi, Afifa; Spector, Aimee; Orrell, Martin

doi:10.1002/14651858.cd009125.pub2

Cited by 137 publications

(93 citation statements)

References 132 publications

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“…Evidence-based treatments exist for older adults with co-occurring depression and cognitive impairment (42), and collaborative care interventions have been shown to increase access to these treatments, reduce depressive symptoms, and improve chronic medical illness management (43, 44). Further research is needed to examine if these interventions could aid in the prevention of incident strokes.…”

Section: Discussionmentioning

confidence: 99%

The Association of Depression, Cognitive Impairment Without Dementia, and Dementia With Risk of Ischemic Stroke

Davydow

Levine

Zivin

et al. 2015

Psychosomatic Medicine

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Objective To determine if depression, cognitive impairment without dementia (CIND), and/or dementia are each independently associated with risk of ischemic stroke and to identify characteristics that could modify these associations. Methods This retrospective-cohort study examined a population-based sample of 7,031 Americans > 50 years old participating in the Health and Retirement Study (HRS) (1998-2008) who consented to have their interviews linked to their Medicare claims. The 8-item Center for Epidemiologic Studies Depression Scale and/or International Classification of Disease, Ninth Revision, Clinical Modification (ICD-9-CM) depression diagnoses were used to identify baseline depression. The Modified Telephone Interview for Cognitive Status and/or ICD-9-CM dementia diagnoses were used to identify baseline CIND or dementia. Hospitalizations for ischemic stroke were identified via ICD-9-CM diagnoses. Results After adjusting for demographics, medical comorbidities, and health-risk behaviors, CIND alone (Odds Ratio [OR]: 1.37, 95%CI: 1.11, 1.69) and co-occurring depression and CIND (OR: 1.65, 95%CI: 1.24, 2.18) were independently associated with increased odds of ischemic stroke. Depression alone was not associated with odds of ischemic stroke (OR: 1.11, 95%CI: 0.88, 1.40) in unadjusted analyses. Neither dementia alone (OR: 1.09, 95%CI: 0.82, 1.45) nor co-occurring depression and dementia (OR: 1.25, 95%CI: 0.89, 1.76) were associated with odds of ischemic stroke after adjusting for demographics. Conclusions CIND as well as co-occurring depression and CIND are independently associated with increased risk of ischemic stroke. Individuals with co-occurring depression and CIND represent a high-risk group that may benefit from targeted interventions to prevent stroke.

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Section: Discussionmentioning

confidence: 99%

The Association of Depression, Cognitive Impairment Without Dementia, and Dementia With Risk of Ischemic Stroke

Davydow

Levine

Zivin

et al. 2015

Psychosomatic Medicine

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“…Furthermore, between 30 % [11, 12] and 50 % [13] of people with dementia also experience elevated symptoms of depression. However, despite depression being one of the most common mental health difficulties experienced by people living with dementia [14], access to evidence-based psychological therapies remains limited [15].…”

Section: Introductionmentioning

confidence: 99%

“…However, despite depression being one of the most common mental health difficulties experienced by people living with dementia [14], access to evidence-based psychological therapies remains limited [15]. This treatment gap [16] exists despite growing evidence identifying cognitive behavioural therapy (CBT) as an effective intervention for treating depression in people with dementia [12], partly due to costs of delivery and a lack of trained therapists [17–19]. …”

Section: Introductionmentioning

confidence: 99%

Behavioural activation written self-help to improve mood, wellbeing and quality of life in people with dementia supported by informal carers (PROMOTE): a study protocol for a single-arm feasibility study

Farrand

Woodford

Llewellyn

et al. 2016

Pilot Feasibility Stud

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BackgroundIncreases in life expectancy have resulted in a global rise in dementia prevalence. Dementia is associated with poor wellbeing, low quality of life and increased incidence of mental health difficulties such as low mood or depression. However, currently, there is limited access to evidence-based psychological interventions for people with dementia experiencing low mood and poor wellbeing. Behavioural activation-based self-help, supported by informal carers and guided by mental health professionals, may represent an effective and acceptable solution.Methods/designThe present study is a phase II (feasibility) single-arm trial informed by the Medical Research Council complex interventions research methods framework. Up to 50 dementia participant/informal carer dyads will be recruited from a variety of settings including primary care, dementia-specific health settings and community outreach. People living with dementia will receive behavioural activation-based self-help and be supported by their informal carer who has received training in the skills required to support the self-help approach. In turn, during the use of the intervention, the informal carer will be guided by mental health professionals to help them work through the materials and problem solve any difficulties. Consistent with the objectives of feasibility studies, outcomes relating to recruitment from different settings, employment of different recruitment methods, attrition, data collection procedures, clinical delivery and acceptability of the intervention will be examined. Clinical outcomes for people with dementia (symptoms of depression and quality of life) and informal carers (symptoms of depression and anxiety, carer burden and quality of life) will be measured pre-treatment and at 3 months post-treatment allocation.DiscussionThis study will examine the feasibility and acceptability of a novel behavioural activation-based self-help intervention designed to promote wellbeing and improve low mood in people living with dementia, alongside methodological and procedural uncertainties associated with research-related procedures. As determined by pre-specified progression criteria, if research procedures and the new intervention demonstrate feasibility and acceptability, results will then be used to inform the design of a pilot randomised controlled trial (RCT) to specifically examine remaining methodological uncertainties associated with recruitment into a randomised controlled design.Trial registrationCurrent Controlled Trials ISRCTN42017211

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“…Moreover, as evidenced in another meta-analytic review psychological approaches (e.g. cognitive behavioral therapy, interpersonal therapy and counseling) added to usual care may reduce symptoms of depression and anxiety for people with MCI (Orgeta et al, 2014). It is also suggested that meditative stress management interventions (e.g.…”

mentioning

confidence: 99%

A Novel Non-Pharmaceutical Treatment for Patients with Mild Cognitive Impairment

Darviri¹,

Zavitsanou²,

Delikou³

et al. 2016

PSYCH

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Mild cognitive impairment (MCI) represents a pre-dementia stage. Currently, there is no evidence for long-term efficacy of pharmacological treatment for preventing conversion to clinical dementia. Healthy lifestyle modifications, cognitive training and psychosocial initiatives are strongly recommended. This was an 8-week parallel randomized two-armed study. Eligible patients were randomized to intervention and control group, with the intervention group receiving the PSAI intervention including cognitive training, healthy lifestyle and stress management. Standardized questionnaires were used pre-and post-intervention. The between group analysis revealed a significant improvement in cognitive aspects, depression, stress, anxiety and self-efficacy post-intervention (p < 0.05, r > 0.5). Nine patients in the intervention group had one point increase in the MMSE score and one patient had a two-point increment post-intervention. Future studies should expand these preliminary findings to larger samples, neuroimaging measurements and longer follow-up in order to ascertain PSAI's role in preventing conversion to clinical dementia.

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Psychological treatments for depression and anxiety in dementia and mild cognitive impairment

Abstract: Psychological treatments for depression and anxiety in dementia and mild cognitive impairment.

Cited by 137 publications

References 132 publications

The Association of Depression, Cognitive Impairment Without Dementia, and Dementia With Risk of Ischemic Stroke

The Association of Depression, Cognitive Impairment Without Dementia, and Dementia With Risk of Ischemic Stroke

Behavioural activation written self-help to improve mood, wellbeing and quality of life in people with dementia supported by informal carers (PROMOTE): a study protocol for a single-arm feasibility study

A Novel Non-Pharmaceutical Treatment for Patients with Mild Cognitive Impairment

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