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Chapter 9 - Psychotherapy and Cognitive Disorders

from Part 3 - Special Topics in Psychotherapy in Later Life

Published online by Cambridge University Press:  09 January 2020

By
Cynthia A. Kraus-Schuman ,
Melissa L. Sanchez ,
Karen M. Benson  and
Ali Abbas Asghar-Ali
Edited by
Rajesh R. Tampi ,
Brandon Yarns ,
Kristina F. Zdanys  and
Deena J. Tampi
Rajesh R. Tampi
Affiliation:
Case Western Reserve University, Ohio
Brandon Yarns
Affiliation:
VA Greater Los Angeles Healthcare System
Kristina F. Zdanys
Affiliation:
University of Connecticut
Deena J. Tampi
Affiliation:
Diamond Healthcare Corporation
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Summary

This chapter reviews the most researched psychotherapeutic interventions for individuals with cognitive impairment (CI) and common symptoms targeted by these interventions. Elements of assessment and psychotherapy modifications to consider when working with individuals with dementia are also discussed. Assessment components might include clarification of medical symptom overlap, collateral information, assessment instruments developed for individuals with cognitive difficulties, and incorporating consultation with other specialties. In general, clinicians should consider using simplified skills, increasing the number and frequency of sessions, shortening sessions, reducing group size, and providing more guidance during skill instruction and practice when working with individuals with cognitive impairments. Despite their promise and recommendations for their use, nonpharmacological therapies for individuals with dementia have a small research base and warrant continued development and evaluation.

Keywords

psychotherapydementiaolder adultsanxietydepressioncognitive behavioral therapyproblem-solving therapymindfulness
Type
Chapter
Information
Psychotherapy in Later Life , pp. 139 - 149
Publisher: Cambridge University Press
Print publication year: 2020

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References

World Health Organization. Dementia. Retrieved from: www.who.int/news-room/fact-sheets/detail/dementia (October 18, 2018).Google Scholar
American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 5th ed. Arlington, VA: American Psychiatric Publishing; 2013.Google Scholar
Kales, HC, Gitlin, LN, Lyketsos, CG. Management of neuropsychiatric symptoms of dementia in clinical settings: recommendations from a multidisciplinary expert panel. J Am Geriatr Soc. 2014;62:762–769.CrossRefGoogle ScholarPubMed
Rehm, IC, Stargatt, J, Willison, AT, Reser, MP, Bhar, SS. Cognitive behavioral therapy for older adults with anxiety and cognitive impairment: Adaptations and illustrative case study. J Cogn Psychother. 2017;31(1):72–88.Google Scholar
Folstein, MF, Folstein, SE, McHugh, PR. “Mini-mental state.” A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res. 1975;12 :189–198.CrossRefGoogle ScholarPubMed
Nasreddine, ZS, Phillips, NA, Bédirian, V, et al. The Montreal Cognitive Assessment, MoCA: a brief screening tool for mild cognitive impairment. J Am Geriatr Soc. 2005 ; 53(4):695–699.Google Scholar
Seignourel, PJ, Kunik, ME, Snow, L, Wilson, N, Stanley, M. Anxiety in dementia: a critical review. Clin Psychol Rev. 2008;28:1071–1082.Google Scholar
Lopez, O. L., Becker, I. T., Sweet, R. A.. Non-cognitive symptoms in mild cognitive impairment subjects. Neurocase. 2005;11:65–71.Google Scholar
Enache, D, Winblad, B, Aarsland, D. Depression in dementia: epidemiology, mechanisms, and treatment. Curr Opin Psychiatry. 2011;24(6):461–472.CrossRefGoogle ScholarPubMed
Palmer, K, Berger, AK, Monastero, R, Winblad, B, Bäckman, L, Fratiglioni, L. Predictors of progression from mild cognitive impairment to Alzheimer disease. Neurology. 2007;68:1596–1602.Google Scholar
Solfrizzi, V, D’Introno, A, Colacicco, AM, et al. Incident occurrence of depressive symptoms among patients with mild cognitive impairment–the Italian Longitudinal Study on Aging. Dement Geriatr Cogn Disord. 2007;24:55–64.Google Scholar
Neville, C, Teri, L. Anxiety, anxiety symptoms, and associations among older people with dementia in assisted-living facilities. Int J Ment Health Nurs. 2011;20:195–201.Google Scholar
Schultz, SK, Hoth, A, Buckwalter, K. Anxiety and impaired social function in the elderly. Ann Clin Psychiatry. 2004;16(1):47–51.CrossRefGoogle ScholarPubMed
Gibbons, LE, Teri, L, Logsdon, R, et al. Anxiety symptoms as predictors of nursing home placement in patients with Alzheimer’s disease. J Clin Geropsychol. 2002;8(4):335–342.Google Scholar
Lyketsos, CG, Carillo, MC, Ryan, JM, et al. Neuropsychiatric symptoms in Alzheimer’s disease. Alzheimers Dement. 2011;7:532–539. doi:10.1016/j.jalz.2011.05.2410Google Scholar
Shankar, KK, Walker, M, Frost, D, et al. The development of a valid and reliable scale for rating anxiety in dementia (RAID). Aging Ment Health. 1999;3:39–49.Google Scholar
Alexopoulos, GS, Abrams, RC, Young, RC, Shamoian, CA. Cornell scale for depression in dementia. Biol Psychiatry. 1998;23 :271–84.Google Scholar
Teri, L, Gallagher-Thompson, D. Cognitive-behavioral interventions for treatment of depression in Alzheimer’s patients. Gerontologist. 1991;31(2):413–416.Google Scholar
Hunt, LJ, Covinsky, KE, Yaffe, K, et al. Pain in community-dwelling older adults with dementia: results from the National Health and Aging Trends Study. J Am Geriatr Soc. 2015;63:1503–1511.Google Scholar
Husebo, BS, Achterberg, WP, Lobbezoo, F, et al. Pain in patients with dementia: A review of pain assessment and treatment challenges. Norsk Epidemiologi. 2012;22(2):243–251.Google Scholar
Kraus, CA, Seignourel, P, Balasubramanyam, V, et al. Cognitive behavioral treatment for anxiety in patients with dementia: two case studies. J Psychiatr Pract. 2008;14:186–192.Google Scholar
Stanley, MA, Calleo, J, Bush, AL, et al. The peaceful mind program: a pilot test of a cognitive-behavioral therapy-based intervention for anxious patients with dementia. Am J Geriatr Psychiatry. 2013;21(7):696–708. doi: 10.1016/j.jagp.2013.01.007Google Scholar
Paukert, AL, Kraus-Schuman, C, Wilson, N, et al. The peaceful mind manual: a protocol for treating anxiety in persons with dementia. Behav Modif. 2013;37(5):631–664.Google Scholar
Kipling, T, Bailey, M, Charlesworth, G. The feasibility of a cognitive behavioural therapy group for men with mild/moderate cognitive impairment. Behav Cogn Psychother. 1999;27(02):189–193.Google Scholar
Koder, DA. Treatment of anxiety in the cognitively impaired elderly: Can cognitive-behavior therapy help? Int Psychogeriatr. 1998:10(02):173–182.Google Scholar
García-Alberca, JM. Cognitive-behavioral treatment for depressed patients with Alzheimer’s disease. An open trial. Arch Gerontol Geriatr. 2017;71:1–8.Google Scholar
Spector, A, Charlesworth, G, King, M, et al. Cognitive-behavioral therapy for anxiety in dementia: pilot randomized controlled trial. Br Jf Psychiatry. 2015;206:509–516. doi:10.1192/bjp.bp.113.140087CrossRefGoogle Scholar
Teri, L, Logsdon, RG, Uomoto, J, McCurry, SM. Behavioral treatment of depression in dementia: a controlled clinical trial. J Gerontol. 1997;52B(4):159–166.Google Scholar
Snow, AL, Jacobs, ML. Pain in persons with dementia and communication impairment. In: Pachana, NA, Laidlaw, K, editors. The Oxford handbook of clinical geropsychology. New York: Oxford University Press; 2014. p. 876–908.Google Scholar
Clifford, PA, Cipher, DJ, Roper, KD, Snow, AL, Molinari, V. Cognitive-behavioral interventions for long-term care residents with physical and cognitive disabilities. In: Gallagher-Thompson, D, Steffen, AM, Thompson, LW, editors. Handbook of behavioral and cognitive therapies with older adults. New York: Springer; 2008. p. 76–101.Google Scholar
Cipher, DJ, Clifford, PA, Roper, KD. The effectiveness of geropsychological treatment in improving pain, depression, behavioral disturbances, functional disability, and health care utilization in long-term care. Clin Gerontol. 2007;30(3):23–40.Google Scholar
Charlesworth, G, Sadek, S, Schepers, A, Spector, A. Cognitive behavior therapy for anxiety in people with dementia: a clinician guideline for a person-centered approach. Behav Modif. 2015;39(3):390–412.Google Scholar
Nezu, AM, Nezu, CM. Problem-solving training home based primary care treatment manual. Washington, DC: Veteran’s Health Administration; 2015.Google Scholar
Kiosses, DN, Ravdin, LD, Gross, JJ, et al. Problem adaptation therapy for older adults with major depression and cognitive impairment: A randomized clinical trial. JAMA Psychia. 2015;72(1):22–30.CrossRefGoogle ScholarPubMed
Renn, BN, Areán, PA. Psychosocial treatment options for major depressive disorder in older adults. Curr Treat Options Psychiatry. 2017;4(1):1–12.Google Scholar
Alexopoulos, G, Raue, P, Kiosses, D, et al. Problem-solving therapy and supportive therapy in older adults with major depression and executive dysfunction effect on disability. Arch Gen Psychiatry. 2011;68(1):33–41.Google Scholar
Alexopoulos, G, Raue, P, Arean, P. Problem-solving therapy versus supportive therapy in geriatric major depression with executive dysfunction. Am J Geriat Psychiatry. 2003;11(1):46–52.Google Scholar
Arean, PA, Raue, P, Mackin, RS, et al. Problem-solving therapy and supportive therapy in older adults with major depression and executive dysfunction. Am J Psychiatry. 2010;167(11):1391–1398.Google Scholar
Gustavson, KA, Alexopoulos, GS, Niu, GC, et al. Problem-solving therapy reduces suicidal ideation in depressed older adults with executive dysfunction. Am J Geriatr Psychiatry. 2016;24(1):11–17.Google Scholar
Arean, P, Hegel, M, Vannoy, S, et al. Effectiveness of problem-solving therapy for older, primary care patients with depression: results from the IMPACT project. Gerontologist. 2008;48(3):311–323.Google Scholar
Choi, NG, Marti, CN, Bruce, ML, et al. Six-month postintervention depression and disability outcomes of in-home telehealth problem-solving therapy for depressed, low-income homebound older adults. Depress Anxiety. 2014;31:653–661.Google Scholar
Kiosses, DN, Alexopoulos, GS. Problem-solving therapy in the elderly. Curr Treat Options Psychiatry. 2014;1(1):15–26.Google Scholar
Gellis, ZD, Nezu, AM. Integrated depression care for homebound medically ill older adults: using evidence-based problem-solving therapy. In: Sorocco, KH, Lauderdale, S, editors. Cognitive behavior therapy with older adults: innovations across care settings. New York: Springer; 2011. p. 391–420.Google Scholar
Arean, PA, Raue, P, Mackin, RS, et al. Problem-solving therapy and supportive therapy in older adults with major depression and executive dysfunction. Am J Psychiatry. 2010;167(11):1391–1398.Google Scholar
Kabat-Zinn, J. Full catastrophe living: using the wisdom of your body and mind to face stress, pain, and illness. New York: Dell; 1990.Google Scholar
Serpa, JG, Taylor, SL, Tillisch, K. Mindfulness-based stress reduction (MBSR) reduces anxiety, depression, and suicidal ideation in veterans. Med Care. 2014;52:S19–S24.Google Scholar
Wong, WP, Coles, J, Chambers, R, et al. The effects of mindfulness on older adults with mild cognitive impairment. J Alzheimers Dis Rep. 2017;1(1):181–193.Google Scholar
Wells, RE, Kerr, CE, Wolkin, J. Meditation for adults with mild cognitive impairment: a pilot randomized trial. J Am Geriatr Soc. 2013;61(4):642–645.CrossRefGoogle ScholarPubMed
Churcher Clarke, A, Chan, JMY, Stott, J, et al. An adapted mindfulness intervention for people with dementia in care homes: feasibility pilot study. Int J Geriatr Psychiatry. 2017;32(12):e123–e131.Google Scholar
Kovach, CR, Evans, C, Sattell, L, et al. Feasibility and pilot testing of a mindfulness intervention for frail older adults and individuals with dementia. Res Gerontol Nurs. 2018;11(3):137–150.Google Scholar
Paller, KA, Creery, JD, Florczak, SM, et al. Benefits of mindfulness training for patients with progressive cognitive decline and their caregivers. Am J Alzheimers Dis Other Dement. 2014;30(3):257–267.CrossRefGoogle ScholarPubMed
Wetherell, JL, Hershey, T, Hickman, S, et al. Mindfulness-based stress reduction for older adults with stress disorders and neurocognitive difficulties. J Clin Psychiatry. 2017;78(7):e734–e743.Google Scholar
McBee, L. Mindfulness practice with the frail elderly and their caregivers. Top Geriatr Rehabil. 2003;19(4):257–264.Google Scholar
Subramanian, P, Woods, B. The impact of individual reminiscence therapy for people with dementia: systematic review. Expert Rev Neurother. 2012:12(5):545–555.Google Scholar
Haight, BK, Gibson, F, Michel, Y. The Northern Ireland life review/life storybook project for people with dementia. Alzheimers Dement. 2006;2:56–58.Google Scholar
Subramanian, P, Woods, B, Whitaker, C. Life review and life story books for people with mild to moderate dementia: a randomized controlled trial. Aging Ment Health. 2014;18(3):363–375.Google Scholar
Thorgrimsen, L, Schweitzer, P, Orrell, M. Evaluating reminiscence for people with dementia: a pilot study. Arts Psychother. 2002;29(2):93–97.Google Scholar
Bohlken, J, Weber, SA, Siebert, A, et al. Reminiscence therapy for depression in dementia. GeroPsych. 2017;30:145–151. doi: 10.1024/1662-9647/a000175Google Scholar
Woods, B, Spector, AE, Jones, CA, Orrell, M, Davies, SP. Reminiscence therapy for dementia. Cochrane Database Syst Rev. 2009;2:1–36.Google Scholar
Moniz Cook, E, De Vugt, M, Verhey, F, James, I. Functional analysis‐based interventions for challenging behavior in dementia. Cochrane Database Syst Rev. 2009;3:1–7.Google Scholar
Cummings, JL, Mega, MS, Gray, K, et al. The neuropsychiatric inventory: comprehensive assessment of psychopathology in dementia. Neurology. 1994;44:2308–2314.Google Scholar
Cohen-Mansfield, J. Nonpharmacologic interventions for inappropriate behaviors in dementia: a review, summary, and critique. Am J Geriatr Psychiatry. 2001;9(4):361–381.Google Scholar
McGee, JS, Bratkovich, KL. Assessment and cognitive-behaviorally oriented interventions for older adults with dementia. In: Sorocco, KH, Lauderdale, S, editors). Cognitive behavior therapy with older adults: innovations across settings. New York: Springer; 2011. p. 219–261.Google Scholar
Karel, MJ, Teri, L, McConnell, E, Visnic, S, Karlin, BE. Effectiveness of expanded implementation of STAR-VA for managing dementia-related behaviors among veterans. Gerontologist. 2015;56(1):126–134. doi:10.1093/geront/gnv068Google Scholar

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