Psychological interventions may improve depression and quality of life in people with dementia, according to an updated systematic review in the Cochrane Database of Systematic Reviews. The review is the first to suggest the effectiveness of talk therapy in the patient population.

“Previous evidence into the clinical effectiveness of psychological treatments has been limited,” said lead author Vasiliki Orgeta, PhD, associate professor in the psychiatry division at University College London. “Reporting on the most up-to-date evidence, 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.”

The review included 29 studies with 2599 participants. Some 24 studies involved people with dementia, and 5 focused on people with mild cognitive impairment. The studies were published between 1997 and 2020, and 15 focused on cognitive behavioral therapies (CBT), 11 on supportive and counseling therapies, 3 on mindfulness-based cognitive therapy, and 1 on interpersonal therapy. All generally aimed to support well-being, reduce distress, and enhance coping.

According to the review, CBT appeared to slightly reduce depressive symptoms in people with depression and mild cognitive impairment and may improve depression remission rates. CBT also showed a small positive effect on quality of life and ability to manage daily activities.

Related: Meta-analysis: Global Prevalence of Major Depression in Older Adults Tops 13%

Evidence supporting other specific psychological interventions for depression, as well as their effects on anxiety on participants, was uncertain. Researchers noted, however, that they identified 14 ongoing studies that they expect will provide more evidence in the coming years.

In the context of ineffective drugs often prescribed to patients with dementia and depression, evidence supporting an effect with some psychological interventions was welcomed by authors of the review.

“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,” said Dr Ortega. “We want people who experience cognitive impairment and dementia to have the same access to mental health treatments as everyone else.”

According to the review, evidence was of moderate quality overall, enough to warrant recommendations supporting the use of talk therapies in the study population.

“There is now good enough quality evidence to support the use of psychological treatments for people with dementia, rather than prescribing medications, and without the risk of drug side effects,” said paper coauthor Phuong Leung, PhD, of University College London. “What we need now is more clinicians opting for talk therapies for their patients and commitment to funding further high-quality research in this area.”

References

Orgeta V, Leung P, Del-Pino-Casado R, et al. Psychological treatments for depression and anxiety in dementia and mild cognitive impairment. Cochrane Database Syst Rev. 2022;4(4):CD009125. doi: 10.1002/14651858.CD009125.pub3

Talk therapy may alleviate depression and improve quality of life for people with dementia. News release. University College London. April 25, 2022. Accessed May 13, 2022.