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

Aimee Spector, Georgina Charlesworth, Michael King, Miles Lattimer, Susan Sadek, Louise Marston, Amritpal Rehill, Juanita Hoe, Afifa Qazi, Martin Knapp, Martin Orrell (2015)

Please note: this is a legacy publication from CPEC (formely PSSRU at LSE).

British Journal of Psychiatry 206 6 509-516

Available online: 19 February 2015

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.