Patients With Dementia May Benefit From Cognitive Behavioral Therapy, Mindfulness

Jessica Nye, PhD
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The objective of this systematic review was to evaluate the efficacy of cognitive behavioral therapy and adaptations in managing mood and insomnia in people with dementia.

The following article is a part of conference coverage from the American Psychiatric Association Annual Meeting 2021, held virtually from May 1 to 3, 2021. The team at Psychiatry Advisor will be reporting on the latest news and research conducted by leading experts in psychiatry. Check back for more from the APA 2021.
 

Cognitive behavioral therapy (CBT) was found in a systematic review to be beneficial for the treatment of patients with dementia who had mild cognitive impairment. These findings were presented during the American Psychiatric Association annual meeting held virtually May 1 to 3, 2021.

Publication databases were searched by researchers at The University of Texas between 2019 and 2020 for studies of CBT and dementia. A total of 12 studies were included in this analysis. The studies used CBT (n=7), mindfulness with some elements from CBT(n=4), or mixed modalities (n=1).

More than half (n=7) of the studies found that CBT (n=4) and mindfulness (n=6) improved depression (n=4), anxiety (3), quality of life (n=2), and insomnia (n=1). After long-term follow-up, however, the positive effect from CBT became insignificant for 1 study.

The therapy integrated the caregivers of the patients with dementia in 4 studies, and 2 studies addressed the burden and depression of the caregivers. The caregiver interventions included problem-solving skills and providing general guidance.

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There were 3 studies that used memory, content, and adherence adaptations aimed at improving the efficacy of the CBT. These adaptations comprised decreased content, increased repetition, reminders via telephone calls between sessions, more frequent shorter sessions, and reduced group sizes.

A single study reported a negative outcome from CBT, and 3 studies found mixed outcomes from CBT (n=2) and mixed modalities (n=1).

There was high bias due to lack of blinding and some bias due to randomization.

These data suggested the goal-oriented intervention of CBT may benefit patients with dementia who have mild cognitive impairment by reducing symptoms of depression and anxiety and improving quality of life. Although some evidence showed that this intervention may improve sleep quality, further study is needed to assess the overall efficacy of CBT for the treatment of insomnia among patients with dementia.

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Reference

Jin JW, Nowakowski S, Taylor A, Medina LD, Kunik ME. Cognitive behavioral therapy for mood and insomnia in persons with dementia: A systematic review. Presented at: APA annual meeting May 1-3, 2021. Abstract/Poster 4138.