Psychological treatments for depression and anxiety in dementiaand mild cognitive impairment: Systematic review andmeta-analysis

BackgroundAnxiety and depression are common in people with dementia and mildcognitive impairment (MCI), but there is uncertainty about theeffectiveness of both pharmacological and psychological therapies.AimsTo evaluate the evidence of effectiveness of psychological treatments intreating depression and anxiety in people with dementia and MCI.MethodWe carried out a systematic review and meta-analysis of randomisedcontrolled trials (RCTs) of psychological treatment versus usual care inpeople with dementia and MCI. Primary outcomes were symptoms of anxietyand depression. Secondary outcomes were quality of life, ability toperform daily activities, neuropsychiatric symptoms, cognition andcaregivers' self-rated depressive symptoms.ResultsWe included six RCTs, involving 439 participants with dementia, whichused cognitive–behavioural therapy, interpersonal therapy, counselling ormultimodal interventions including a specific psychological therapy. Wefound beneficial effects for both depression and anxiety. Overall, thequality of the evidence was moderate for depression and low for anxiety,due to the methodological limitations of the studies we identified andthe limited number of trials.ConclusionsThe evidence from six RCTs suggests that psychological treatments areeffective in reducing symptoms of depression and anxiety for people withdementia. There is a need for high-quality, multicentre trials includingstandardised, well-defined interventions.Declarations of interestA.Q., A.S. and M.O. are investigators in one of the included studies.