The Peaceful Mind Program: A Pilot Test of a Cognitive–Behavioral Therapy–Based Intervention for Anxious Patients with Dementia

Abstract

Objectives To assess feasibility and to conduct a preliminary evaluation of outcomes following Peaceful Mind, a CBT-based intervention for anxiety in dementia, relative to usual care (UC). Design Pilot randomized controlled trial including assessments at baseline, 3 and 6 months Setting Houston, TX Participants 32 outpatients diagnosed with mild (47%) or moderate (53%) dementia receiving care through outpatient clinics at the Veterans Affairs medical center, Baylor College of Medicine, Harris County Hospital District and community day centers for dementia, and their collaterals, who spent at least 8 hours a week with them. Intervention Peaceful Mind included up to 12 weekly in-home sessions (mean = 8.7, SD = 2.27) during the initial 3 months and up to eight brief telephone sessions (mean = 5.4, SD = 3.17) during months 3 to 6, involving self-monitoring for anxiety, deep breathing, and optional skills (coping self-statements, behavioral activation and sleep management). Patients learned skills, and collaterals served as coaches. In UC, patients received diagnostic feedback; and providers were informed of inclusion status. Measurements Neuropsychiatric Inventory-Anxiety subscale, Rating Anxiety in Dementia scale, Penn State Worry Questionnaire-Abbreviated, Geriatric Anxiety Inventory, Geriatric Depression Scale, Quality of Life in Alzheimer’s disease, Patient Health Questionnaire, Client Satisfaction Questionnaire Results Feasibility was demonstrated with regard to recruitment, attrition, and treatment characteristics. At 3 months, clinicians rated patients receiving Peaceful Mind as less anxious, and patients rated themselves as having higher quality of life; collaterals reported less distress related to loved ones’ anxiety. Although significant positive effects were not noted in other outcomes or at 6-month follow-up, the pilot nature of the trial prohibits conclusions about efficacy. Conclusions Results support that Peaceful Mind is ready for future comparative clinical trials.

Anxiety Symptoms in Amnestic Mild Cognitive Impairment Are Associated with Medial Temporal Atrophy and Predict Conversion to Alzheimer Disease

“…This may, in part, be attributable to the tendency to subsume anxiety symptoms within the rubric of depression(58). Future research should clarify the clinical profile of anxiety and its association with AD in community samples of aMCI, and evaluate whether progression to AD can be delayed through routine monitoring and timely management of anxiety symptoms in aMCI; for example, using cognitive-behavioral interventions developed for anxiety in dementia(59). …”

Validating the Penn Acoustic Neuroma Quality of Life Scale in a Sample of Dutch Patients Recently Diagnosed With Vestibular Schwannoma

“…Therefore, QoL inventory will be interpreted from a personal point of view (i.e., subjective) (1,33). The question remaining is whether patients are influenced by either conversations with their physician or nurse practitioners on their tumor, or whether they are influenced by more widely available information (e.g., internet).…”

O3‐02‐02: Cognitive Behavioural Therapy (Cbt) for Anxiety in Dementia: A Pilot Randomised Controlled Trial

“…One method for providing flexibility is to have a range of 'modules' within the manual, an approach used both here and in the 'Peaceful Mind' CBT studies in the US [11,12].…”

“…There is some evidence for the feasibility of CBT for anxiety and depression in dementia, primarily through case studies and two small RCTs in the US [e.g. 2,10,11,12]. They all concluded that larger trials are needed.…”