New therapies may help people with dementia who suffer from depression

About one in three people with dementia also suffer from depression. The New York Times reports on new therapies to treat older adults with dementia who suffer from depression. They address loneliness, hopelessness and anxiety in everyday life through different forms of cognitive behavioral therapy.

In one case the psychologist worked with a 74-year old woman with mild dementia to identify her best qualities. The psychologist wrote them down and handed the paper to the patient to keep. The patient would have that paper to review when she was feeling down.

PATH, developed at Weill-Cornell Medical Center, uses written information and film tools to treat anxiety and depression in people who struggle to remember. The goal is to help them solve challenges that present themselves on a regular basis. If possible, PATH engages a caregiver, often the patient’s spouse or family member, to help benefit from the tools. Early studies show that the therapy reduces depressive symptoms. 

The Peaceful Mind program, developed at Baylor College of Medicine uses a simple form of cognitive behavorial therapy. It engages patients in activities that give them joy. One study shows that this person-centered approach appeared to help reduce anxiety after three months. And patients said that they had a better quality of life. But, after six months, the benefits were less clear.

Yet another program, developed at University College London, provides patients with a stack of cards to remind them of different strategies for dealing with stress and anxiety.

Much as dementia can lead to depression, people who suffer from depression have a higher likelihood of developing dementia. It is not clear why, but some believe that people with depression also often have high levels of the stress hormone cortisol, which can be harmful to the brain’s hippocampus. The hippocampus stores long-term memories.

People with dementia often lack motivation and are scared. They tend to know that they are losing their ability to remember. Depression and anxiety can aggravate their dementia. Psychotherapy can be safer than prescription drugs patients with dementia and depression.

Some research suggests that older adults with dementia are less likely to be helped by antidepressant drugs. These drugs often have dangerous side effects. For example, Prozac and other SSRIs prescribed for depression, as well as benzodiazepines, such as Klonopin and Xanax, are linked to falls in older adults. Haloperidol, risperidone and other antipsychotics and psychotropics, prescribed for anxiety, can increase the likelihood of death for patients with dementia.

Here’s more from Just Care:

• Medicare covers depression screenings
• Safety at home for people with dementia
• What’s a dementia directive?
• HIPAA and why you need a health care proxy
• Concerns about your antidepressant? Talk to your doctor!