4.5 Article

Managing depressive symptoms in people with mild cognitive impairment and mild dementia with a multicomponent psychotherapy intervention: a randomized controlled trial

Journal

INTERNATIONAL PSYCHOGERIATRICS
Volume 33, Issue 3, Pages 217-231

Publisher

CAMBRIDGE UNIV PRESS
DOI: 10.1017/S1041610220000216

Keywords

dementia; mild cognitive impairment; cognitive rehabilitation; cognitive behavioral therapy; reminiscence therapy; psychosocial intervention; depressive symptoms; MADRS

Funding

  1. Norwegian Health Association
  2. Old Age Psychiatry Research Network
  3. Telemark Hospital Trust
  4. Vestfold Trust (TeVe)
  5. Department of Old Age Psychiatry
  6. Oslo University Hospital
  7. Civitan Norway Research Foundation of Alzheimer's Disease

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The study evaluated the CORDIAL program and found that this psychosocial intervention effectively reduced depressive symptoms in MCI and dementia patients, with effects persisting for up to 6 months post-intervention.
Objective: To evaluate the feasibility and effectiveness of the CORDIAL program, a psychosocial intervention consisting of cognitive behavioral therapy (CBT), cognitive rehabilitation, and reminiscence to manage depressive symptoms for people with mild cognitive impairment (MCI) or dementia. Design: We conducted a randomized controlled trial, based on a two-group (intervention and control), pre-/post-intervention design. Setting: Participants were recruited from five different old age psychiatry and memory clinics at outpatients' hospitals. Participants: Hundred and ninety-eight people with MCI or early-stage dementia were included. Intervention: The intervention group (n = 100) received 11 individual weekly sessions of the CORDIAL program. This intervention includes elements from CBT, cognitive rehabilitation, and reminiscence therapy. The control group (n = 98) received treatment-as-usual. Measurements: We assessed Montgomery-angstrom sberg Depression Rating Scale (MADRS) (main outcome), Neuropsychiatric Inventory Questionnaire, and Quality of Life in Alzheimer's disease (secondary outcomes) over the course of 4 months and at a 10-month follow-up visit. Results: A linear mixed model demonstrated that the depressive symptoms assessed by MADRS were significantly more reduced in the intervention groups as compared to the control group (p < 0.001). The effect persisted for 6 months after the intervention. No significant differences between groups were found in neuropsychiatric symptoms or quality of life. Conclusion: Our multicomponent intervention, which comprised 11 individual sessions of CBT, cognitive rehabilitation, and reminiscence therapy, reduced depressive symptoms in people with MCI and dementia.

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