Clinicians’ experiences of anxiety in patients with dementia

Goyal, A.R. Dementia. Published online: 14 July 2016

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Image source: Susan Lockhart – Wellcome Images // CC BY-NC-ND 4.0

Image shows illustration demonstrating the feeling of anxiety.

Since anxiety in patients with dementia is a complex, understudied phenomenon, this paper presents clinicians’ experiences of anxiety in this population. Semi-structured interviews were conducted with seven clinicians experienced with dementia in elderly patients (65 years and above), and then evaluated via qualitative content analysis.

Analysis revealed three main categories: A reaction to loss and worries, symptoms of anxiety and depression interfere with each other, and anxiety in dementia—a multidisciplinary task.

Anxiety in this population is perhaps best understood as a reaction to loss and worries, and existential in nature by the participants. Care interventions can reduce or prevent anxiety symptoms in this population. However, when anxiety co-exists with depression it might be difficult to attenuate these symptoms through care measures alone. To better identify and treat the condition, valid dementia-specific anxiety-screening instruments are necessary.

Read the abstract here

Clinicians’ experiences of anxiety in patients with dementia

Knut Engedal & Siren Eriksen Clinicians’ experiences of anxiety in patients with dementiaDementia July 14, 2016 

 

B0003584 MRI of the brain overlaid with "anxiety"
image source: Mark Lythgoe, Wellcome Images // CC BY-NC-ND 4.0

Since anxiety in patients with dementia is a complex, understudied phenomenon, this paper presents clinicians’ experiences of anxiety in this population.

Semi-structured interviews were conducted with seven clinicians experienced with dementia in elderly patients (65 years and above), and then evaluated via qualitative content analysis.

Analysis revealed three main categories: A reaction to loss and worries, symptoms of anxiety and depression interfere with each other, and anxiety in dementia—a multidisciplinary task.

Anxiety in this population is perhaps best understood as a reaction to loss and worries, and existential in nature by the participants. Care interventions can reduce or prevent anxiety symptoms in this population. However, when anxiety co-exists with depression it might be difficult to attenuate these symptoms through care measures alone. To better identify and treat the condition, valid dementia-specific anxiety-screening instruments are necessary.

Cognitive–behavioural therapy for anxiety in dementia

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.

Read the full article via Cognitive–behavioural therapy for anxiety in dementia: pilot randomised controlled trial | The British Journal of Psychiatry.