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

Robert Howard*, Elizabeth Cort, Charlotte Rawlinson, Martin Wiegand, Anne Downey, Vanessa Lawrence, Sube Banerjee, Peter Bentham, Chris Fox, Rowan Harwood, Rachel Hunter, Gill Livingston, Esme Moniz-Cook, Monica Panca, Malgorzata Raczek, Chineze Ivenso, Gregor Russell, Alan Thomas, Philip Wilkinson, Nicholas FreemantleRebecca Gould

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

3 Citations (Scopus)

Abstract

INTRODUCTION: Trials of effectiveness of treatment options for depression in dementia are an important priority. METHODS: Randomized controlled trial to assess adapted Problem Adaptation Therapy (PATH) for depression in mild/moderate dementia caused by Alzheimer's disease. RESULTS: Three 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). DISCUSSION: An 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.

Original languageEnglish
Pages (from-to)2990-2999
Number of pages10
JournalAlzheimer's and Dementia
Volume20
Issue number4
DOIs
Publication statusPublished - Apr 2024

Keywords

  • Alzheimer's disease
  • clinical trial
  • depression
  • mood
  • problem adaptation therapy
  • psychological
  • psychotherapy

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