Depression in dementia best treated by non-drug approaches: research

Research led by UNSW Sydney’s Center for Healthy Brain Aging (CHeBA) has confirmed that treating symptoms of depression is most effective when a non-pharmacological approach is adopted, in people living with dementia.

Depression is a common psychological symptom associated with dementia and is estimated to occur in between 10% and 62% of people living with the condition.

Despite the failure to rely on medications highlighted in large-scale studies, pharmacological approaches continue to be used to treat depression in dementias.

The review and meta-analysis, published in Aging Research Reviews, investigates a variety of non-pharmacological approaches for symptoms of depression in dementia. It identified 37 relevant non-pharmacological studies from 27,126 articles published between 2012 and 2020.

Lead Author and Postdoctoral Fellow at CHeBA (formerly at the Dementia Center for Research Collaboration (DCRC) UNSW) Dr Claire Burley said the findings support a positive link between non-pharmacological approaches and reduced symptoms of depression in people living with dementia .

“Our goal was to provide an updated review of non-pharmacological approaches to managing depression in dementia – the evidence, clinical significance, and sustainability of various non-pharmacological approaches to treating depression in dementia.”

Edward Caser, who co-founded a private label company, has experienced too much prescription of pharmaceuticals in elderly care while caring for his mother who has Alzheimer’s disease.

“I have witnessed first-hand the unnecessary pressure of multiple medications to control behavior in my mother,” he said.

“I’ve seen the benefits of adopting a personalized approach with my mother, and I support methods that prevent drugs.”

According to UNSW Professor Henry Brodaty AO, Co-Director of CHeBA, the findings have statistical and clinical significance.

“We found that there is a great potential to reduce symptoms of depression in dementia – without the use of medication,” Brodaty said. “This is even more relevant because randomized trials of antidepressant drugs have not been shown to reduce depression in people living with dementia.”

The research highlighted that using methods such as memory, cognitive stimulation and rehabilitation, music-based approaches, and education and training had the potential to reduce symptoms of depression.

“Psychosocial approaches should be first-line consideration for treating depression. An even more compelling reason is that antidepressants are associated with side effects, while psychosocial interventions are free of these.

“Pharmacological approaches should only be considered if psychosocial approaches have been proven to be ineffective or in cases of urgency,” Brodaty said.

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Depression in dementia best treated by non-drug approaches: research

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