June 28, 2022
Depression is common in people with Alzheimer’s disease, and people with the condition are often prescribed antidepressants and other behavior-modifying medications that can have harmful side effects. In some cases these drug treatments can add to the patient’s problems and deteriorating mood, and can make the burden for caregivers even worse. But a new analysis found that for many people in the earlier stages of Alzheimer’s disease, talk therapies, in which the patient talks with a psychotherapist, can help to ease depression and improve quality of life.
The study was published as part of the Cochrane Database of Systemic Reviews, which assesses the effectiveness of various treatments by combining findings from earlier research. It incorporated evidence from 29 trials of psychological treatments for people with dementia or mild cognitive impairment, a medical state marked by memory problems that may progress to full-blown Alzheimer’s. The analysis involved 2,599 study participants in total.
The psychological treatments included various forms of “talk therapy,” including cognitive behavior therapy, or CBT, as well as various forms of support and counseling. All were aimed at supporting the patient’s well-being, easing distress and improving the overall ability to cope.
Talk therapies helped to ease symptoms of depression in people with Alzheimer’s disease and other forms of dementia, as well as those with mild cognitive impairment. People who had these interventions, particularly cognitive behavioral therapy, also reported having a better quality of life and were better able to carry out day-to-day activities like getting dressed and preparing meals.
Cognitive behavior therapy, which can be relatively short term, lasting for 10 sessions or so, was shown to be particularly effective in easing depression in people with dementia. CBT aims to challenge people’s negative beliefs about themselves. For instance, someone with early Alzheimer’s who is feeling overwhelmed and who believes they can’t take care of themself might be taught to break down daily tasks into smaller, achievable parts, boosting their mood, confidence and abilities.
“We found that these treatments, and specifically those focusing around supporting people with dementia to use strategies to reduce distress and improve well-being, are effective in reducing symptoms of depression,” said the study’s lead author, Vasiliki Orgeta, an associate professor at University College London Psychiatry. “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 towards increasing access to psychological services for people with dementia across the globe.”
By ALZinfo.org, The Alzheimer’s Information Site. Reviewed by Marc Flajolet, Ph.D., Fisher Center for Alzheimer’s Research Foundation at The Rockefeller University.
Source: Vasiliki Orgeta, Phuong Leung, Rafael Del-Pino-Casado, et al: “Psychological treatments for depression and anxiety in dementia and mild cognitive impairment.” Cochrane Database of Systemic Reviews, April 25, 2022