THURSDAY, March 25, 2021 (HealthDay News) – Exercise, mental stimulation and massage are among therapies without drugs that are just as good or better than drugs in treating depression in patients with dementia, researchers say.
They reviewed 256 studies that included a total of more than 28,000 people with dementia with or without major depression.
Medications alone were not more effective than conventional care in treating depression in these patients. But according to research, 10 therapies were more effective than conventional care. It was published on March 24 in BMJ.
“Non-drug approaches have been associated with a significant reduction in depressive symptoms in people with dementia and without a diagnosis of major depressive disorder,” said researchers led by Jennifer Watt, of the Department of Geriatric Medicine at the University of Toronto.
Useful therapies included: cognitive stimulation; exercise; reminiscence therapy (which helps people with dementia remember events, people, and places in their lives); mental stimulation with a cholinesterase inhibitor (a drug used to treat dementia); and massage and touch therapy.
Other useful therapies include multidisciplinary care; psychotherapy in combination with reminiscence therapy and environmental modification; occupational therapy; exercise combined with social interaction and mental stimulation, and animal therapy.
Three of these approaches – massage and touch therapy, mental stimulation with a cholinesterase inhibitor, and mental stimulation combined with exercise and social interaction – have been shown to be more effective than some medications, Watt and colleagues said in a journal statement.
The researchers said their findings suggest that doctors should use drug-free methods to treat depression and loneliness in people with dementia.
The research had limitations, the researchers noted. For example, it did not assess the severity of depressive symptoms, effects on different types of dementia, or the potential costs or harms of drug and drug-free interventions.
However, they said that the strengths of the study were the large number of reviewed articles and the use of a recognized clinical scale for the symptoms of depression.
Healthcare providers, carers and patients all have a role to play in applying these findings in practice, the authors argue.
Of the 50 million people worldwide with dementia, about 16% have also been diagnosed with major depression, and 32% have symptoms of depression without a formal diagnosis, the researchers noted.
The U.S. National Institute on Aging has more information on dementia.
SOURCE: BMJ, news release, March 24, 2021