The growing popularity of prescribing a ‘social’ activity – such as regular exercise sessions, for example – as a treatment alternative to medication has been backed by researchers focusing on dementia.
In an online, peer-reviewed paper published today by The BMJ, an international team led by Jennifer A Watt, from the Knowledge Translation Program at the Li Ka Shing Knowledge Institute, St Michael’s Hospital, Toronto, urges doctors and other clinicians to consider adopting drug-free approaches.
Dr Watt and her colleagues argue that options such as exercise and social interaction appear to be just as – or even more – effective than drugs in reducing the symptoms of depression in people with dementia.
The research team analysed the results of more than 250 studies involving more than 28,000 people with dementia, some of whom had a major depressive disorder, while some did not.
Drug approaches alone were no more effective than usual care, the team found, while 10 interventions were linked to a greater reduction in the symptoms of depression when compared with usual care. These were
cognitive stimulation with a cholinesterase inhibitor
massage and touch therapy
psychotherapy combined with reminiscence therapy and environmental modification
exercise combined with social interaction and cognitive stimulation
Three interventions – massage and touch therapy, cognitive stimulation with a cholinesterase inhibitor, and cognitive stimulation combined with exercise and social interaction – were found to be more effective than some drugs.
Non-drug approaches were associated with a meaningful reduction in symptoms of depression in people with dementia and without a diagnosis of a major depressive disorder [Dr Jennifer Watt and colleagues]
50 million people worldwide have a diagnosis of dementia
about 16 per cent of them also have a diagnosis of a major depressive disorder
32 per cent have symptoms of depression, but no formal diagnosis
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