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Psychological treatments for depression and anxiety in dementia and mild cognitive impairment: Systematic review and meta-analysis

  • Vasiliki Orgeta (a1), Afifa Qazi (a2), Aimee Spector (a3) and Martin Orrell (a4)
Abstract
Background

Anxiety and depression are common in people with dementia and mild cognitive impairment (MCI), but there is uncertainty about the effectiveness of both pharmacological and psychological therapies.

Aims

To evaluate the evidence of effectiveness of psychological treatments in treating depression and anxiety in people with dementia and MCI.

Method

We carried out a systematic review and meta-analysis of randomised controlled trials (RCTs) of psychological treatment versus usual care in people with dementia and MCI. Primary outcomes were symptoms of anxiety and depression. Secondary outcomes were quality of life, ability to perform daily activities, neuropsychiatric symptoms, cognition and caregivers' self-rated depressive symptoms.

Results

We included six RCTs, involving 439 participants with dementia, which used cognitive–behavioural therapy, interpersonal therapy, counselling or multimodal interventions including a specific psychological therapy. We found beneficial effects for both depression and anxiety. Overall, the quality of the evidence was moderate for depression and low for anxiety, due to the methodological limitations of the studies we identified and the limited number of trials.

Conclusions

The evidence from six RCTs suggests that psychological treatments are effective in reducing symptoms of depression and anxiety for people with dementia. There is a need for high-quality, multicentre trials including standardised, well-defined interventions.

Declarations of interest

A.Q., A.S. and M.O. are investigators in one of the included studies.

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Copyright
This is an open access article distributed under the terms of the Creative Commons Attribution (CC BY) licence.
Corresponding author
Vasiliki Orgeta, 6th Floor, Maple House, 149 Tottenham Court Road, London W1T 7NF, UK. Email: v.orgeta@ucl.ac.uk
Footnotes
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See editorial, pp. 286–287 this issue.

Footnotes
References
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Psychological treatments for depression and anxiety in dementia and mild cognitive impairment: Systematic review and meta-analysis

  • Vasiliki Orgeta (a1), Afifa Qazi (a2), Aimee Spector (a3) and Martin Orrell (a4)
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