- Dementia is a leading cause of death and disability among the elderly in the United States.
- Two symptoms often coincide with the condition: depression and anxiety.
- New research indicates that talk therapy can significantly reduce depression and anxiety among individuals with dementiaffering the implications of better treatment methods.
- More research is needed to better understand the effectiveness of speech therapy in different stages of dementia.
Dementia is a disorder that affects a person’s memory and cognition and interferes with their daily functioning.
There is currently no cure for dementia, but different treatment and lifestyle approaches can help individuals deal with the condition.
The findings provide insight into improved treatment approaches for people with dementia.
The researchers analyzed data from 25,15,402 participants diagnosed with depression or anxiety who received speech therapy from 2012 to 2019. Of that number, 1,549 were also diagnosed with dementia.
The treatment was accessed through the UK’s National Health Service (NHS) initiative, Improving Access to Psychological Therapies (IAPT), which combines cognitive behavioral therapy (CBT), counseling, and guided self-help sessions.
Researchers found that 63% of dementia patients experienced fewer symptoms of depression and anxiety after treatment, while about 40% of patients saw signs of these symptoms disappear completely.
Participants with dementia over 65 years old had significantly higher success rates than their younger counterparts, but this did not surprise the researchers.
“Research has shown that older adults tend to have better treatment outcomes at IAPT on average than younger people,” Dr. amber johnD., of the UCLA Department of Psychology and Language Studies and senior author of the research, told Healthline.
“So it is plausible that this could also be the case for people with dementia, [although] This has not yet been systematically tested.”
Additionally, individuals with depression or anxiety but not dementia experienced slightly higher success rates after IAPT. In this group, 70% of patients noted an improvement in symptoms, and 47% fully recovered.
Whatever the case, the findings point to a step forward in treating depression and anxiety among people with dementia.
“I was not surprised that people with dementia could benefit [from IAPT]although I was a little surprised by how effective it was,” John said. “I was encouraged by the results.”
Dementia cannot be classified as a single disease. Types of dementia include:
- Alzheimer’s disease (AD)
- Lewy body dementia (LBD)
- Vascular dementia
- Parkinson’s disease
- Frontotemporal dementia
Across all types of dementia, John noted, “38% of people with mild dementia, 41% with moderate dementia, and 37% with severe dementia have been reported to have depression.”
She added that risk factors for developing dementia may include:
- Social isolation or loneliness
- Reaction to diagnosis and perceived effects of diagnosis
- Responding to physical and cognitive symptoms
- Medication side effects
Symptoms of dementia-related anxiety and depression can also vary depending on the stage of dementia a person is in, which may be severe after diagnosis.
According to Dr. Jason Krellmana neuropsychologist at Columbia University Irving Medical Center, the various symptoms associated with dementia “are often driven by the affected person’s perception of the cognitive deficit and its impact on activities of daily living.”
Krellman explained that as dementia progresses to moderate or severe, depressive features may worsen.
“People are less able to develop good coping strategies and remember to use them consistently and effectively,” Krellman told Healthline, adding that dementia may also lead to apathy and dissociation as it progresses.
Dr. Reza Hosseini Gomia neuropsychiatrist and co-founder of Frontier Psychiatry In Montana, he said that this level of apathy “is a lack of motivation” that causes a person to retreat from their life and the world around them.
“It’s very specific in dementia and very common,” Gumi told Healthline, adding that in the later stages of dementia, anxiety may also occur with other complications.
According to Krellman, certain types of dementia may present a higher risk of depression and anxiety.
“People with dementia caused by cerebrovascular disease are more likely to develop psychological distress than those with Alzheimer’s dementia,” he said.
Gumi added that the type of depression that occurs with dementia is often a unique entity.
Prescription medications are commonly used to treat depression and anxiety at all ages — but they may not always be appropriate to treat symptoms of dementia.
Gumi said apathy in dementia, in particular, “responds differently to medications,” noting that drugs like Prozac and Zoloft may not be effective for people with dementia. Others, such as Citalopram and Celexa, may be of benefit, he said.
It’s not entirely known why some medications are less effective in treating depression and anxiety among people with dementia.
However, one theory is that depression in dementia is, as Gumi described it, a “different biological entity.”
This means that while medications can create a more variable response, talk therapy may have the potential to provide benefits on a more comprehensive and broad scale.
Dr. said. Alex DemetriouDouble Board Certified in Psychiatry and Sleep Medicine and Founder of Menlo Park Psychiatry and Sleep Medicine and BrainfoodMD.
“Any attention or investigation into the way our feelings work can reduce feelings of depression or anxiety. Awareness alone can go a long way. In the hands of a skilled therapist, these feelings can be recognized and improved.”
According to Krellman, speech therapy can help individuals with early dementia:
- Get support in handling a diagnosis
- Learn how to emotionally adapt to cognitive changes
- Solve practical problems and issues such as financial planning
- Balance their future care options
Because the UCL study used pre-recorded data, John noted that they “were only able to determine whether or not there was a registered diagnosis of dementia.”
Therefore, the researchers did not study the stages of dementia among the participants.
However, John hypothesized that it was “highly likely” that participants with dementia receiving IAPT were in the early stages of the condition.
At this point, she said, they still have many of their faculties and are aware of what’s going on — which means that traditional treatments, such as cognitive-behavioral therapy, can still be dealt with.
But as a person’s dementia progresses, there is likely to be a “high degree of memory, planning, and language difficulties,” John said.
This means that speech therapies must be adjusted accordingly to suit the needs of the individual with dementia depending on the severity of their diagnosis.
Dementia affects short-term memory before long-term memories, so many people with this condition can still talk about their childhood and earlier years.
Memories therapy involves a therapist or counselor who encourages the individual to share stories and experiences from their past.
according to Institute of Excellence for Social CareMemories “can give people with dementia a sense of competence and confidence.”
The memories approach can be extended beyond talking, too.
“We’ve found that in people with mild dementia, we put them in an environment where they are reminded of their younger days, [such as playing] “The music they used to listen to, it really has a positive effect,” Gumi said.
Get support from loved ones
As dementia progresses, friends and family can play a critical role in ensuring that their loved ones continue to listen to and practice such mechanisms.
“Repetition and reinforcement are key when teaching coping and problem-solving skills to individuals with dementia in psychotherapy,” Krellman said.
“Involving close friends, family members, or other caregivers is often critical to helping a person remember the skills being taught in therapy.”
Breathing exercises and meditation
Confusion and memory loss can worsen anxiety in people with dementia.
But Demetriou explained that practicing mindfulness techniques to bring her back to the present can encourage a sense of calm.
can include ‘breathing’ [exercises]And the [guided] Relax, and even meditate, he said.
If you or a loved one has been diagnosed with dementia and you’re interested in knowing how talk therapy can help alleviate any mental health concerns, talking with your primary care doctor is a good starting point.
Gumi noted that taking family members with you can help you advocate for your needs.
You can also look for a psychiatrist or counselor who specializes in dementia.
For example, file Alzheimer’s Association Helpline It is a 24/7 service with consultants who are able to advise on finding a psychiatrist or counsellor.
In addition, online databases, such as those offered by American Psychological Associationn(aPalestinian Authority)allows you to search for therapists by zip code and specialty – including Alzheimer’s disease and dementia.
Depression and anxiety are common, concurrent symptoms of various types of dementia.
While some medications have produced mixed results in treating dementia-related depression and anxiety, new research suggests that talk therapy could be a useful alternative.
The effectiveness of conventional talk therapy, such as CBT, is likely to be most important in the early stages of dementia. However, the methods can be adapted to help those who are in later stages of the disease.
“The appropriateness of treatment and the necessary adaptations must be determined on a case-by-case basis,” John said.