Adapted problem adaptation therapy for depression in mild to moderate Alzheimer's disease dementia: A randomized controlled trial

Author:

Howard Robert1,Cort Elizabeth1,Rawlinson Charlotte1,Wiegand Martin2,Downey Anne2,Lawrence Vanessa3,Banerjee Sube4,Bentham Peter5,Fox Chris6,Harwood Rowan7,Hunter Rachel2,Livingston Gill1,Moniz‐Cook Esme8,Panca Monica2,Raczek Malgorzata9,Ivenso Chineze10,Russell Gregor11,Thomas Alan12,Wilkinson Philip13,Freemantle Nicholas14,Gould Rebecca1

Affiliation:

1. Division of Psychiatry University College London London UK

2. Priment Clinical Trials Unit University College London London UK

3. David Goldberg Centre (H1.01) King's College London London UK

4. University of Plymouth Plymouth Devon UK

5. Birmingham and Solihull NHS Trust Birmingham UK

6. University of East Anglia Norwich Norfolk UK

7. University of Nottingham Queen's Medical Centre Nottingham UK

8. University of Hull Hull UK

9. Brighton and Sussex School of Medicine Brighton East Sussex UK

10. Aneurin Bevan NHS Trust St Cadoc's Hospital Newport South Wales UK

11. Bradford District Care Foundation Trust Shipley UK

12. University of Newcastle Campus for Ageing and Vitality Newcastle upon Tyne UK

13. Department of Psychiatry University of Oxford Warneford Hospital Oxford UK

14. Comprehensive Clinical Trials Unit University College London London UK

Abstract

AbstractINTRODUCTIONTrials of effectiveness of treatment options for depression in dementia are an important priority.METHODSRandomized controlled trial to assess adapted Problem Adaptation Therapy (PATH) for depression in mild/moderate dementia caused by Alzheimer's disease.RESULTSThree hundred thirty‐six participants with mild or moderate dementia, >7 on Cornell Scale for Depression in Dementia (CSDD), randomized to adapted PATH or treatment as usual. Mean age 77.0 years, 39.0% males, mean Mini‐Mental State Examination 21.6, mean CSDD 12.9. For primary outcome (CSDD at 6 months), no statistically significant benefit with adapted PATH on the CSDD (6 months: −0.58; 95% CI −1.71 to 0.54). The CSDD at 3 months showed a small benefit with adapted PATH (−1.38; 95% CI −2.54 to −0.21) as did the EQ‐5D (−4.97; 95% CI −9.46 to −0.48).DISCUSSIONAn eight‐session course of adapted PATH plus two booster sessions administered within NHS dementia services was not effective treatment for depression in people with mild and moderate dementia. Future studies should examine the effect of more intensive and longer‐term therapy.

Publisher

Wiley

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