Can Cognitive Behaviour Therapy Help Dementia Patients?

Whilst visiting my nana at the weekend, I saw that her motivation had gone and that she seemed to be finding comfort in doing the same routine everyday – almost as though she has intentionally isolated herself or even institutionalised herself!

It made me think about how I could support my nana better and I thought out cognitive behaviour therapy.

However, is there such as thing as cognitive behavioural therapy for people with dementia?

With Dementia and dementia related illnesses such as MCI, there is a large proportion of patients suffering underlying issues such as anxiety and depression, in fact there is an estimated 50% of patients experiencing some symptoms of depression.

Depression can decrease quality of life, worsen dementia symptoms and increase carer stress.  Anxiety is also common in people with dementia and has a similarly negative impact.  Therefore, can Cognitive Behaviour Therapy help?  And if it can how would it need adapting to ensure the best possible outcome for the patient?

What is Cognitive Behaviour Therapy?

Cognitive behavioural therapy (CBT) is a widely used psychological therapy. It was initially developed to treat depression in adults without dementia and can be effective in treating both anxiety and depression. 

I believe that in its current form it cannot be used to help people with dementia as it requires thinking and memory abilities that may be affected by the condition.  But that is just my opinion.

Adapting Cognitive Behaviour Therapy

There has been some research into adapting CBT to help those with dementia, but this is still in the early stages.

Dr Stott has already undertaken some preliminary work on this project, including consulting with experts in CBT and people affected by dementia to determine the aims of the project.

Dr Stott aims to better understand the skills that people with dementia need in order to take part in CBT.

I believe that once this study is completed then Dr Stott will conclude that CBT is feasible for people with mild to moderate dementia and clinically significant anxiety.

Dementia in the under 65's

Doctors often miss symptoms of dementia in younger people, assuming they are too young to be suffering from the condition. Dementia cases have been known to occur among those in their 50s, 40s, and even in their 30s.

In a report published in 2014 by the Alzheimer’s Society, the London School of Economics and King’s College Institute of Psychiatry, Jeremy Hughes the chief executive of the society said

“For too long dementia has been perceived as a natural part of ageing which only affects the oldest of the old in our society. The risk of developing dementia does increase with age, but the reality is that dementia is caused by diseases of the brain that don’t discriminate.”

People in the UK who have dementia before the age of 65, accounts for roughly 5% of all cases of dementia.

As more doctors are recognising the possibility of younger people suffering from dementia, the following reasons have come to light:

1)    Pollution 

Some research suggests environmental factors are playing a role in dementia becoming common in young people. An article in the Daily Mail states that there may be a “silent epidemic” which is increasing rates of young on-set of dementia in a short time.

Colin Pritchard, a researcher from Bournemouth University, said

“The environmental changes in the last 20 years have seen increases in the human environment of petro-chemicals – air transport, quadrupling of motor vehicles, insecticides and so on … [the rate of increase in incidence of dementia in young people] suggests a silent or even a “hidden” epidemic, in which environmental factors must play a major part.” 

2)    People with learning disabilities

Sadly, people who suffer from learning disabilities are at a greater risk of younger onset of dementia, especially Alzheimer’s. One in ten people with a learning disability develops dementia at a younger age, as per some studies.

Those suffering from Down’s syndrome are at a greater risk. One in 50 people develop the condition aged 30-39, one in ten aged 40-49 and one in three people may develop Alzheimer’s in their 50s.

3)    Amyloid build-up

Amyloid build-up is a hallmark of Alzheimer’s, that is commonly found in the brains of seniors who have the disease. A recent study has found evidence of amyloid build-up in the brains of people as young as 20 years old.

The toxic amyloid build-up was evident irrelevant of age and health but as per the study, it was not possible to know if the younger adults may develop Alzheimer at a young age or even later.

Despite the prevalence of dementia, it is still not known for sure what factors cause dementia, nor does it have a cure. Similarly, though the incidence of dementia in younger people is increasing, no one cause has been identified, though it is understood that there are various risk factors that increase the probability of it its incidence.