Hostname: page-component-745bb68f8f-l4dxg Total loading time: 0 Render date: 2025-02-11T19:25:27.596Z Has data issue: false hasContentIssue false
  • English
  • Français

Adjustment, depression, and anxiety in mild cognitive impairment and early dementia: a systematic review of psychological intervention studies

Published online by Cambridge University Press:  14 October 2013

Bridget Regan  and
Laura Varanelli
Bridget Regan*
Affiliation:
Lincoln Centre for Research on Ageing, Australian Institute for Primary Care and Ageing, La Trobe University, Plenty Rd, Bundoora, Victoria 3086, Australia Monash Ageing Research Centre (MONARC), Monash University, Victoria, Australia
Laura Varanelli
Affiliation:
Lincoln Centre for Research on Ageing, Australian Institute for Primary Care and Ageing, La Trobe University, Plenty Rd, Bundoora, Victoria 3086, Australia
*
Correspondence should be addressed to: Bridget Regan, Lincoln Centre for Research on Ageing, Australian Institute for Primary Care and Ageing, La Trobe University, Plenty Rd, Bundoora, Victoria 3086, Australia. Phone: +61-3-94793700. Email: B.Regan@latrobe.edu.au.
Get access

Abstract

Background:

Many people with mild cognitive impairment (MCI) or early dementia suffer from concomitant depression and anxiety disorders, which in some cases, may be related difficulties adjusting to their diagnosis and associated cognitive problems. Successful adjustment and alleviation of depression and anxiety symptoms in these people is of critical importance for quality of life and may also help prevent, or delay, further cognitive decline. A variety of psychosocial intervention approaches has been trialed with this group.

Method:

The literature was systematically searched for community-based intervention studies that aim to improve depression, anxiety, or adjustment. Studies were included or excluded using a priori criteria. Once included, the quality of studies was evaluated using pre-set criteria.

Results:

Seventeen of 925 studies identified through literature databases and manual searches met the inclusion criteria. Of these, 16 were considered to be of at least “adequate quality.” These included seven randomized controlled trials and eight pre–post studies. A diverse range of psychotherapeutic approaches, formats (individual or group), outcome measures, inclusion criteria, and cultural contexts were apparent, making comparisons between studies challenging.

Conclusions:

Several studies have demonstrated positive findings in the treatment of depression in older adults with early dementia using problem solving and modified cognitive behavior therapy (CBT) approaches. Amongst the large range of approaches trialed to improve adjustment and quality of life for patients with MCI and early dementia, some approaches, such as modified CBT, have shown promise. There is a need for replication studies using more rigorous methodology before clear clinical recommendations can be made.

Keywords

MCIdementiapsychosocialinterventions
Type
Review Article
Information
International Psychogeriatrics , Volume 25 , Issue 12 , December 2013 , pp. 1963 - 1984
Copyright
Copyright © International Psychogeriatric Association 2013 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Alexopoulos, G. S., Raue, P. and Arean, P. (2003). Problem-solving therapy versus supportive therapy in geriatric major depression with executive dysfunction. The American Journal of Geriatric Psychiatry, 11, 46–52.CrossRefGoogle ScholarPubMed
American Psychiatric Association (1994). Diagnostic and Statistical Manual of Mental Disorders. Washington, DC: American Psychiatric Association.Google Scholar
Bains, J., Birks, J. and Dening, T. (2009). Antidepressants for treating depression in dementia (review). Cochrane Database of Systematic Reviews.Google Scholar
Bennett, D. A., Schneider, J. A., Tang, Y., Arnold, S. E. and Wilson, R. S. (2006). The effect of social networks on the relation between Alzheimer's disease pathology and level of cognitive function in old people: a longitudinal cohort study. The Lancet Neurology, 5, 406–412.CrossRefGoogle ScholarPubMed
Blieszner, R. and Roberto, K. A. (2010). Care partner responses to the onset of mild cognitive impairment. Gerontologist, 50, 11–22.CrossRefGoogle Scholar
Burgener, S. C., Yang, Y., Gilbert, R. and Marsh-Yant, S. (2008). The effects of a multimodal intervention on outcomes of persons with early-stage dementia. American Journal of Alzheimer's Disease and Other Dementias, 23, 382–394.CrossRefGoogle ScholarPubMed
Burns, A.et al. (2005). Brief psychotherapy in Alzheimer's disease: randomised controlled trial. British Journal of Psychiatry, 187, 143–147.CrossRefGoogle ScholarPubMed
Centre for Reviews and Dissemination (2009). Systematic Reviews: CRD's Guidance for Undertaking Reviews in Healthcare. York: University of York.Google Scholar
Cheston, R. (1998). Psychotherapeutic work with people with dementia: a review of the literature. The British Journal of Medical Psychology, 71, 211–231.CrossRefGoogle ScholarPubMed
Cheston, R. and Jones, R. (2009). A small-scale study comparing the impact of psycho-education and exploratory psychotherapy groups on newcomers to a group for people with dementia. Aging and Mental Health, 13, 420–425.CrossRefGoogle Scholar
Cheston, R., Jones, K. and Gilliard, J. (2003). Group psychotherapy and people with dementia. Aging and Mental Health, 7, 452–461.CrossRefGoogle ScholarPubMed
Chung, J. C. C. (2009). An intergenerational reminiscence programme for older adults with early dementia and youth volunteers: values and challenges. Scandinavian Journal of Caring Sciences, 23, 259–264.CrossRefGoogle ScholarPubMed
Evers, A. W. M., Kraaimaat, F. W., van Lankveld, W., Jongen, P. J. H., Jacobs, J. W. G. and Bijlsma, J. W. J. (2001). Beyond unfavorable thinking: the Illness Cognition Questionnaire for chronic diseases. Journal of Consulting and Clinical Psychology, 69, 1026–1036.CrossRefGoogle ScholarPubMed
Fratiglioni, L., Paillard-Borg, S. and Winblad, B. (2004). An active and socially integrated lifestyle in late life might protect against dementia. The Lancet Neurology, 3, 343–353.CrossRefGoogle ScholarPubMed
Frazer, C. J., Christensen, H. and Griffiths, C. M. (2005). Systematic review: effectiveness of treatments for depression in older people. Medical Journal of Australia, 182, 627–632.CrossRefGoogle ScholarPubMed
Garand, L., Dew, M. A., Urda, B., Lingler, J. H., Dekosky, S. T. and Reynolds, C. F. (2007). Marital quality in the context of mild cognitive impairment. Western Journal of Nursing Research, 29, 976–992.CrossRefGoogle ScholarPubMed
George, D. R. and Singer, M. E. (2011). Intergenerational volunteering and quality of life for persons with mild to moderate dementia: results from a 5-month intervention study in the United States. American Journal of Geriatric Psychiatry, 19, 392–396.CrossRefGoogle ScholarPubMed
Ishizaki, J.et al. (2002). Therapeutic psychosocial intervention for elderly subjects with very mild Alzheimer's disease in a community: The Tajiri project. Alzheimer Disease and Associated Disorders, 16, 261–269.CrossRefGoogle Scholar
Jacobson, N. S., Follette, W. C. and Revenstorf, D. (1984). Psychotherapy outcome research: methods for reporting variability and evaluating clinical significance. Behavior therapy, 15, 336–352.CrossRefGoogle Scholar
Jadad, A. R.et al. (1996). Assessing the quality of reports of randomized clinical trials: is blinding necessary? Controlled Clinical Trials, 17, 1–12.CrossRefGoogle ScholarPubMed
Jha, A., Jan, F., Gale, T. and Newman, C. (2012). Effectiveness of a recovery-orientated psychiatric intervention package on the wellbeing of people with early dementia: a preliminary randomised controlled trial. International Journal of Geriatric Psychiatry. Epub ahead of printGoogle Scholar
Joosten-Weyn Banningh, L. W., Prins, J. B., Vernooij-Dassen, M., Wijnen, H., Olde Rikkert, M. G. and Kessels, R. P. (2010 ). Group therapy for patients with mild cognitive impairment and their significant others: results of a waiting-list controlled trial. Gerontology, 444–454.Google ScholarPubMed
Joosten-Weyn Banningh, L., Vernooij-Dassen, M., Rikkert, M. O. and Teunisse, J. P. (2008). Mild cognitive impairment: coping with an uncertain label. International Journal of Geriatric Psychiatry, 23, 148–154.CrossRefGoogle ScholarPubMed
Kiosses, D. N., Arean, P. A., Teri, L. and Alexopoulos, G. S. (2010). Home-delivered problem adaptation therapy (PATH) for depressed, cognitively impaired, disabled elders: a preliminary study. American Journal of Geriatric Psychiatry, 18, 988–998.CrossRefGoogle ScholarPubMed
Kiosses, D. N., Leon, A. C. and Areán, P. A. (2011). Psychosocial interventions for late-life major depression: evidence-based treatments, predictors of treatment outcomes, and moderators of treatment effects. Psychiatric Clinics of North America, 34, 377–401.CrossRefGoogle ScholarPubMed
Kurz, A., Pohl, C., Ramsenthaler, M. and Sorg, C. (2009). Cognitive rehabilitation in patients with mild cognitive impairment. International Journal of Geriatric Psychiatry, 24, 163–168.CrossRefGoogle ScholarPubMed
Loreck, D. J. and Folstein, M. F. (1993). Depression in Alzheimer disease. In Starkstein, S. E. and Robinson, R. G. (eds.) Depression in Neurologic Disease. The John Hopkins Series in Pyschiatry and Neuroscience (pp. 50–62) Baltimore: John Hopkins University Press.Google Scholar
Lyketsos, C. G., Lopez, O., Jones, B., Fitzpatrick, A. L., Breitner, J. and DeKosky, S. (2002). Prevalence of neuropsychiatric symptoms in dementia and mild cognitive impairment: results from the Cardiovascular Health Study. Journal of the American Medical Association, 288, 1475–1483.CrossRefGoogle ScholarPubMed
McKhann, G., Drachman, D., Folstein, M., Katzman, R., Price, D. and Stadlan, E. M. (1984). Clinical diagnosis of Alzheimer's disease: Report of the NINCDS-ADRDA Work Group under the auspices of Department of Health and Human Services Task Force on Alzheimer's Disease. Neurology, 34, 939–944.CrossRefGoogle ScholarPubMed
Moniz-Cook, E., Gibson, G., Harrison, J. and Wilkinson, H. (2009). Timely psychosocial interventions in a memory clinic. In Moniz Cook, E. D. and Manthorpe, J. (eds.) Early Psychosocial Interventions in Dementia: Evidence Based Practice (pp. 50–70). London: Jessica Kingsley Publishers.Google Scholar
Moniz-Cook, E. and Woods, R. T. (1997). The role of memory clinics and psychosocial intervention in the early stages of dementia. International Journal of Geriatric Psychiatry, 12, 1143–1145.3.0.CO;2-F>CrossRefGoogle Scholar
Morris, J. C. (1993). The Clinical Dementia Rating (CDR): current version and scoring rules. Neurology, 43, 2412–2414.CrossRefGoogle ScholarPubMed
Morris, J. C.et al. (1997). Clinical Dementia Rating training and reliability in multicenter studies: the Alzheimer's disease cooperative study experience. Neurology, 48, 1508–1510.CrossRefGoogle ScholarPubMed
Panza, F., Collaccico, A., Del Parigi, A., Pilotto, A., Scapicchio, P. and Carpurso, A. (2005). Current epidemiology of mild cognitive impairment and other predementia syndromes. American Journal of Geriatric Psychiatry, 13, 633–644.CrossRefGoogle ScholarPubMed
Paukert, A. L.et al. (2010). Peaceful Mind: an open trial of cognitive-behavioral therapy for anxiety in persons with dementia. International Psychogeriatrics, 22, 1012–1021.CrossRefGoogle ScholarPubMed
Petersen, R. C. and Negash, S. (2008). Mild cognitive impairment: an overview. C N S Spectrums, 13, 45–53.CrossRefGoogle ScholarPubMed
Richards, K., Moniz-Cook, E., Duggan, P., Carr, I. and Wang, M. (2003). Defining “early dementia” and monitoring intervention: what measures are useful in family caregiving? Aging and Mental Health, 7, 7–14.CrossRefGoogle ScholarPubMed
Ryburn, B., Wells, Y. and Foreman, P. (2009). Enabling independence: restorative approaches to home care provision for frail older adults. Health and Social Care in the Community, 17, 225–234.CrossRefGoogle ScholarPubMed
Scholey, K. A. and Woods, B. T. (2003). A series of brief cognitive therapy interventions with people experiencing both dementia and depression: a description of techniques and common themes. Clinical Psychology and Psychotherapy, 10, 175–185.CrossRefGoogle Scholar
Scholzel-Dorenbos, C. J., van der Steen, M. J., Engels, L. K. and Olde Rikkert, M. G. (2007). Assessment of quality of life as outcome in dementia and MCI intervention trials: a systematic review. Alzheimer Disease and Associated Disorders, 21, 172–178.CrossRefGoogle ScholarPubMed
Scogin, F., Welsh, D., Hanson, A., Stump, J. and Coates, A. (2005). Evidence based psychotherapies for depression in older adults. Clinical Psychology: Science and Practice, 12, 222–237.Google Scholar
Teri, L., Logsdon, R. G., Uomoto, J. and McCurry, S. M. (1997). Behavioral treatment of depression in dementia patients: a controlled clinical trial. Journals of Gerontology Series B-Psychological Sciences & Social Sciences, 52, 159–166.CrossRefGoogle ScholarPubMed
Waldorff, F. B.et al. (2012) Efficacy of psychosocial intervention in patients with mild Alzheimer's disease: the multicentre, rater blinded, randomised Danish Alzheimer Intervention Study (DAISY). Brittish Medical Journal, 345, e4693Google ScholarPubMed
Wilson, R. S., Arnold, S. E., Schneider, J. A., Li, Y. and Bennett, D. A. (2007a). Chronic distress, age-related neuropathology, and late-life dementia. Psychosomatic Medicine, 69, 47–53.CrossRefGoogle ScholarPubMed
Wilson, K., Mottram, P. and Vassilas, C. (2009). Psychotherapeutic treatments for older depressed people (review). Cochrane Database of Systematic Reviews, Issue 1. Art. No.: CD004853. DOI: 004810.001002/14651858.CD14004853.pub14651852.Google Scholar
Wilson, R. S.et al. (2007b). Loneliness and risk of Alzheimer disease. Archives of General Psychiatry, 64, 234–240.CrossRefGoogle ScholarPubMed
Winblad, B.et al. (2004). Mild cognitive impairment. Beyond controversies, towards a consensus: report of the International Working Group on Mild Cognitive Impairment. Journal of Internal of Medicine, 256, 240–246.CrossRefGoogle Scholar
Woods, B. and Clare, L. (2008). Psychological interventions with people with dementia. In Handbook of the Clinical Psychology of Ageing. New York, NY, John Wiley & Sons Ltd; US: 523–548.CrossRefGoogle Scholar
World Health Organization (1992). International Statistical Classification of Diseases and Related Health Problems (10th Revision). Geneva: WHO.Google Scholar
World Health Organization (1994). The ICD-10 Classification of Mental and Behavioural Disorders: Clinical Descriptions and Diagnostic Guidelines. Geneva: WHO.Google Scholar
World Health Organization (2007). Health Evidence Network: Evidence for Decision Makers. Regional Office for Europe. Geneva: WHO.Google Scholar
Yale, R. (1995). Developing Support Groups for Individuals with Early-stage Alzheimer's Disease: Planning, Implementation, and Evaluation. Baltimore, MD: Health Professions Press.Google Scholar
Yesavage, J. A.et al. (1983). Development and validation of a geriatric depression screening scale: a preliminary report. Journal of Psychiatric Research, 17, 37–49.CrossRefGoogle Scholar