Cognitive-behavioural therapy for anxiety in dementia: pilot randomised controlled trial

Br J Psychiatry. 2015 Jun;206(6):509-16. doi: 10.1192/bjp.bp.113.140087. Epub 2015 Feb 19.

Abstract

Background: Anxiety is common and problematic in dementia, yet there is a lack of effective treatments.

Aims: To develop a cognitive-behavioural therapy (CBT) manual for anxiety in dementia and determine its feasibility through a randomised controlled trial.

Method: A ten-session CBT manual was developed. Participants with dementia and anxiety (and their carers) were randomly allocated to CBT plus treatment as usual (TAU) (n = 25) or TAU (n = 25). Outcome and cost measures were administered at baseline, 15 weeks and 6 months.

Results: At 15 weeks, there was an adjusted difference in anxiety (using the Rating Anxiety in Dementia scale) of (-3.10, 95% CI -6.55 to 0.34) for CBT compared with TAU, which just fell short of statistical significance. There were significant improvements in depression at 15 weeks after adjustment (-5.37, 95% CI -9.50 to -1.25). Improvements remained significant at 6 months. CBT was cost neutral.

Conclusions: CBT was feasible (in terms of recruitment, acceptability and attrition) and effective. A fully powered RCT is now required.

Publication types

  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Anxiety Disorders / economics
  • Anxiety Disorders / therapy*
  • Cognitive Behavioral Therapy / economics
  • Cognitive Behavioral Therapy / methods*
  • Costs and Cost Analysis
  • Dementia / economics
  • Dementia / psychology*
  • Feasibility Studies
  • Female
  • Humans
  • Male
  • Medication Adherence
  • Middle Aged
  • Single-Blind Method
  • Treatment Outcome