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Cognitive–behavioural therapy for anxiety in dementia: pilot randomised controlled trial
- Authors:
- SPECTOR Aimee, et al
- Journal article citation:
- British Journal of Psychiatry, 206(6), 2015, pp.509-516.
- Publisher:
- Cambridge University Press
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. (Publisher abstract)
Factors influencing the person–carer relationship in people with anxiety and dementia
- Authors:
- SPECTOR Aimee, et al
- Journal article citation:
- Aging and Mental Health, 20(10), 2016, pp.1055-1062.
- Publisher:
- Taylor and Francis
Objective: The relationship between people with dementia and their carers is complex and has a significant impact on the dementia experience. The aim of this current study was to determine (1) which factors are associated with the quality of the patient–carer relationship and (2) whether these differ between the two perspectives. Method: Participants (people with dementia and their carers) were taken from a randomised controlled trial of cognitive behaviour therapy for anxiety in dementia. The quality of the relationship from both perspectives, anxiety and depression in both parties; and the quality of life, neuropsychiatric symptoms and cognitive functioning in people with dementia was examined at three time points (baseline, 15 weeks and 6 months). Results: There were 127 observations from 50 dyads (100 individuals) across the three time points. Factors significantly related to quality of relationship from the person with dementia's perspective were their own aggression, agitation, irritability, depression, anxiety and quality of life. Factors significantly associated with quality of relationship from the carer's perspective were their own anxiety and depression, and the depression, irritability, behavioural disturbances and quality of life of the person with dementia. People with dementia generally rated the quality of relationship higher, irrespective of level of dementia, depression or anxiety. Conclusion: This study is novel in that it provides a valuable insight into the impact of mental health on relationship quality for both members of the dyad. The findings emphasise the importance of providing interventions which target mood for both parties, and behavioural problems for people with dementia. (Publisher abstract)