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Feasibility and acceptability of cognitive behavioural therapy in older Japanese people with cognitive decline: a single-arm intervention

Published online by Cambridge University Press:  01 December 2022

Masami Kashimura*
Affiliation:
Faculty of Human Sciences, Department of Psychology, Tokiwa University, 1-430-1, Miwa, Mito-shi, Ibaraki, 310-8585, Japan
Akiko Ishiwata
Affiliation:
Department of Neurology, Nippon Medical School, 1-1-5, Sendagi, Bunkyo-ku, Tokyo 113-8603, Japan
Amane Tateno
Affiliation:
Department of Psychiatry, Nippon Medical School, 1-1-5, Sendagi, Bunkyo-ku, Tokyo 113-8603 Japan
Aimee Spector
Affiliation:
Department of Clinical, Educational and Health Psychology, University College London, Gower Street, London WC1E 6BT, UK
*
*Corresponding author. Email: [email protected]

Abstract

Studies have shown that cognitive behavioural therapy (CBT) for older people with cognitive decline and depression/anxiety improves negative moods. However, CBT research focusing on this population in Japan is limited. This study aimed to evaluate the feasibility of a cognitive behavioural program for people with cognitive decline. Sixteen Japanese patients with mild dementia (n = 3) and mild cognitive impairment (MCI, n = 13) participated in the study. A single-arm, pre–post study was implemented in two hospitals in Japan. The CBT program included eight bi-weekly sessions. The feasibility outcomes (satisfaction, understanding and usefulness) were measured immediately after completing the sessions, and depression, anxiety, quality of life (QOL), neuropsychiatric symptoms, and caregiver burden were measured at three time points (i.e. before, immediately after, and 3-month follow-up). Ten MCI participants attended all sessions and the mean patient satisfaction scores using the Client Satisfaction Questionnaire were 31.0±10.05 out of 32. Linear mixed model analyses demonstrated that the time effect was significant for depression (d = 1.62), anxiety (d = 1.39), and QOL (d = 1.00) for the patients, and significant for anxiety (d = 1.08) for their caregivers. The study found that this CBT program is feasible and acceptable for older Japanese people with cognitive decline. The program also improved patients’ QOL, anxiety and depressive symptoms, and decreased caregivers’ anxiety.

Key learning aims

  1. (1) Recently, studies have shown that CBT for older people living with dementia has been effective in treating their depression and anxiety. However, evidence for the efficacy of CBT and other curative or care options for people living with dementia is limited in Japan.

  2. (2) We studied a short-period CBT program and found that it was likely to be feasible and acceptable for use among older Japanese people with mild cognitive impairment, that it may improve negative mood among this group, and that it may lessen the care burden for caregivers.

  3. (3) Furthermore, we found that caregiver involvement in the implementation of CBT for older people may be effective in improving the mood of family members.

Type
Original Research
Copyright
© The Author(s), 2022. Published by Cambridge University Press on behalf of the British Association for Behavioural and Cognitive Psychotherapies

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References

Further reading

Gallagher-Thompson, D., & Thompson, L.W. (2010). Treating Late-Life Depression: A Cognitive-Behavioral Therapy Approach. Oxford, UK: Oxford University Press.Google Scholar
Knight, B. G. (2004). Psychotherapy with Older Adults. London, UK: SAGE Publications.CrossRefGoogle Scholar
Laidlaw, K., Thompson, L. W., Gallagher-Thompson, D., & Dick-Siskin, L. (2003). Cognitive Behavior Therapy with Older People. Chichester, UK: Wiley-Blackwell.CrossRefGoogle Scholar

References

Arai, Y., Tamiya, N., & Yano, E. (2003). Zarit Kaigohutan shakudo Nihongoban no tanshukuban (J-ZBI_8) no sakusei [The short version of the Japanese version of the Zarit Caregiver Burden Interview (J-ZBI_8)]. Japanese Journal of Geriatrics, 40, 497503. https://doi.org/10.3143/geriatrics.40.497 Google Scholar
Asada, T. (2013). Kousei Roudou Kagaku Kenkyuhi Hojokin. Ninchishou taisaku sougou kenkyu jigyo. Toshibu ni okeru ninchishou yubyoritsu to ninchishou no seikatsu kinou heno taiou. Heisei 23 nendo kara 24 nendo Sogo kenkyu houkokusho [Health and labour science research grants. Research on dementia. Prevalence of dementia in the urban areas of Japan and development of treatment of the daily life disability associated with dementia. Report of comprehensive research for the 23rd to 24th Fiscal year of Heisei, 2013]. http://www.tsukuba-psychiatry.com/wp-content/uploads/2013/06/H24Report_Part1.pdf Google Scholar
Ballard, C., Neill, D., O’Brien, J., McKeith, I. G., Ince, P., & Perry, R. (2000). Anxiety, depression, and psychosis in vascular dementia: prevalence and associations. Journal of Affective Disorders, 59, 97106. https://doi.org/10.1016/S0165-0327(99)00057-9 CrossRefGoogle ScholarPubMed
Bjelland, I., Dahl, A. A., Haug, T. T., & Neckelmann, D. (2002). The validity of the Hospital Anxiety and Depression Scale: an updated literature review. Journal of Psychosomatic Research, 52, 6977. https://doi.org/10.1016/S0022-3999(01)00296-3 CrossRefGoogle ScholarPubMed
Bowling, A. (1995). Measuring Disease: A Review of Disease-Specific Quality of Life Measurement Scales. Open University Press. https://www.mheducation.co.uk/openup/chapters/0335206417.pdf Google Scholar
Cabinet Office (2021). White paper on the aging society: Situation of aging. Available at: https://www8.cao.go.jp/kourei/whitepaper/w-2021/zenbun/03pdf_index.html Google Scholar
Charlesworth, G., Sadek, S., Schepers, A., & Spector, A. (2015). Cognitive behavior therapy for anxiety in people with dementia: a clinician guideline for a person-centered approach. Behavior Modification, 39, 390412. https://doi.org/10.1177/0145445514561317 CrossRefGoogle ScholarPubMed
Cummings, J. L., Mega, M., Gray, K., Rosenberg-Thompson, S., Carusi, D. A., & Gornbein, J. (1994). The Neuropsychiatric Inventory: comprehensive assessment of psychopathology in dementia. Neurology, 44, 23082314. https://doi.org/10.1212/WNL.44.12.2308 CrossRefGoogle ScholarPubMed
Enache, D., Winblad, B., & Aarsland, D. (2011). Depression in dementia: epidemiology, mechanisms, and treatment. Current Opinion in Psychiatry, 24, 461472. https://doi.org/10.1097/YCO.0b013e32834bb9d4 CrossRefGoogle ScholarPubMed
Folstein, M. F., Folstein, S. E., & McHugh, P. R. (1975). ‘Mini-mental state’: a practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12, 189198. https://doi.org/10.1016/0022-3956(75)90026-6 CrossRefGoogle Scholar
Gale, C. R., Allerhand, M., & Deary, I. J. (2012). Is there a bidirectional relationship between depressive symptoms and cognitive ability in older people? A prospective study using the English Longitudinal Study of Ageing. Psychological Medicine, 42, 20572069. https://doi.org/10.1017/S0033291712000402 CrossRefGoogle Scholar
Gulpers, B., Ramakers, I., Hamel, R., Köhler, S., Voshaar, R. O., & Verhey, F. (2016). Anxiety as a predictor for cognitive decline and dementia: a systematic review and meta-analysis. American Journal of Geriatric Psychiatry, 24, 823842. https://doi.org/10.1016/j.jagp.2016.05.015 CrossRefGoogle ScholarPubMed
Hatta, H., Higashi, A., Yashiro, H., Ozasa, K., Hayashi, K., Kiyota, K., Inokuchi, H., Ikeda, J., Fujita, K., Watanabe, Y., & Kawai, K. (1998). Nihongoban no shinraisei to datousei no kentou: Josei wo taisho to shita seiseki [A validation of the hospital anxiety and dipression scale]. Japanese Journal of Psychosomatic Medicine, 38, 309315.Google Scholar
Herrmann, C. (1997). International experiences with the Hospital Anxiety and Depression Scale – a review of validation data and clinical results. Journal of Psychosomatic Research, 42, 1741. https://doi.org/10.1016/S0022-3999(96)00216-4 CrossRefGoogle ScholarPubMed
Heser, K., Tebarth, F., Wiese, B., Eisele, M., Bickel, H., Kohler, M., Mösch, E., Weyerer, S., Werle, J., König, H. H., & Leicht, H. (2013). Age of major depression onset, depressive symptoms, and risk for subsequent dementia: results of the German study on Ageing, Cognition, and Dementia in Primary Care Patients (AgeCoDe). Psychological Medicine, 43, 15971610. https://doi.org/10.1017/S0033291712002449 CrossRefGoogle Scholar
Hidaka, S., Ikejima, C., Kodama, C., Nose, M., Yamashita, Y., Sasaki, M., Kinoshita, T., Tanimukai, S., Mizukami, K., Takahashi, H., & Kakuma, T. (2012). Prevalence of depression and depressive symptoms among older Japanese people: comorbidity of mild cognitive impairment and depression. International Journal of Geriatric Psychiatry, 27, 271279. https://doi.org/10.1002/gps.2715 CrossRefGoogle ScholarPubMed
Hugo, J., & Ganguli, M. (2014). Dementia and cognitive impairment: epidemiology, diagnosis, and treatment. Clinics In Geriatric Medicine, 30, 421442. https://doi.org/10.1016/j.cger.2014.04.001.CrossRefGoogle ScholarPubMed
James, I. A. (2010). Cognitive Behavioural Therapy with Older People: Interventions for those with and without Dementia. London, UK: Jessica Kingsley Publishers.Google Scholar
Kashimura, M., Nomura, T., Ishiwata, A., Kitamura, S., & Tateno, A. (2019). Cognitive behavioral therapy for improving mood in an older adult with mild cognitive impairment: a case report. Journal of Nippon Medical School, 86, 352356. https://doi.org/10.1272/jnms.JNMS.2019_86–603.CrossRefGoogle Scholar
Kaufer, D. I., Cummings, J. L., Ketchel, P., Smith, V., MacMillan, A., Shelley, T., Lopez, O. L., & DeKosky, S. T. (2000). Validation of the NPI-Q, a brief clinical form of the Neuropsychiatric Inventory. Journal of Neuropsychiatry and Clinical Neurosciences, 12, 233239. https://doi.org/10.1176/jnp.12.2.233 CrossRefGoogle ScholarPubMed
Kessler, R. C., Andrews, G., Colpe, L. J., Hiripi, E., Mroczek, D. K., Normand, S. L., Walters, E. E., & Zaslavsky, A. M. (2002). Short screening scales to monitor population prevalences and trends in non-specific psychological distress. Psychological Medicine, 32, 959976. https://doi.org/10.1017/S0033291702006074 CrossRefGoogle ScholarPubMed
Kitamura, T. (1993). Hospital Anxiety and Depression Scale (HADS shakudo). Archives of Psychiatric Diagnostics and Clinical Evaluation, 4, 371372.Google Scholar
Kraus, C. A., Seignourel, P., Balasubramanyam, V., Snow, A. L., Wilson, N. L., Kunik, M. E., Schulz, P. E., & Stanley, M. A. (2008). Cognitive-behavioral treatment for anxiety in patients with dementia: two case studies. Journal of Psychiatric Practice, 14, 186192. https://doi.org/10.1097/01.pra.0000320120.68928.e5 CrossRefGoogle ScholarPubMed
Kroenke, K., & Spitzer, R. L. (2002). The PHQ-9: a new depression diagnostic and severity measure. Psychiatric Annals, 32, 509515. https://doi.org/10.3928/0048-5713-20020901-06.CrossRefGoogle Scholar
Kume, Y., Takahashi, T., Itakura, Y., Lee, S., Makizako, H., Ono, T., Shimada, H., & Ota, H. (2019). Characteristics of mild cognitive impairment in northern Japanese community-dwellers from the ORANGE registry. Journal of Clinical Medicine, 8, 1937. https://doi.org/10.3390/jcm8111937 CrossRefGoogle ScholarPubMed
Logsdon, R. G., Gibbons, L. E., McCurry, S. M., & Teri, L. (2002). Assessing quality of life in older adults with cognitive impairment. Psychosomatic Medicine, 64, 510519. https://doi.org/10.1097/00006842-200205000-00016 CrossRefGoogle ScholarPubMed
Margot-Cattin, I., Kühne, N., Öhman, A., Brorsson, A., & Nygard, L. (2021). Familiarity and participation outside home for persons living with dementia. Dementia, 20, 25262541. https://doi.org/10.1177/14713012211002030 CrossRefGoogle ScholarPubMed
Martin, A., Rief, W., Klaiberg, A., & Braehler, E. (2006). Validity of the Brief Patient Health Questionnaire Mood Scale (PHQ-9) in the general population. General Hospital Psychiatry, 28, 7177. https://doi.org/0.1016/j.genhosppsych.2005.07.003 CrossRefGoogle ScholarPubMed
Matsui, T., Nakaaki, S., Murata, Y., Sato, J., Shinagawa, Y., Tatsumi, H., & Furukawa, T. A. (2006). Determinants of the quality of life in Alzheimer’s disease patients as assessed by the Japanese version of the Quality of Life-Alzheimer’s Disease Scale. Dementia and Geriatric Cognitive Disorders, 21, 182191. https://doi.org/10.1159/000090744 CrossRefGoogle ScholarPubMed
Matsumoto, N., Ikeda, M., Fukuhara, R., Hyodo, T., Ishikawa, T., Mori, T., Toyota, Y., Matsumoto, T., Adachi, H., Shinagawa, S., & Hokoishi, K. (2006). Validity and reliability of the Japanese version of the Neuropsychiatric Inventory Caregiver Distress Scale (NPI D) and the Neuropsychiatric Inventory Brief Questionnaire Form (NPI-Q). Brain and Nerve [No to shinkei], 58, 785790.Google ScholarPubMed
McKay, M., & DuFrene, T. (2011). 30-Minute Therapy for Anxiety: Everything You Need to Know in the Least Amount of Time. New Harbinger Publications.Google Scholar
Mitchell, A. J., Bird, V., Rizzo, M., & Meader, N. (2010). Diagnostic validity and added value of the Geriatric Depression Scale for depression in primary care: a meta-analysis of GDS30 and GDS15. Journal of Affective Disorders, 125, 1017. https://doi.org/10.1016/j.jad.2009.08.019 CrossRefGoogle ScholarPubMed
Monastero, R., Mangialasche, F., Camarda, C., Ercolani, S., & Camarda, R. (2009). A systematic review of neuropsychiatric symptoms in mild cognitive impairment. Journal of Alzheimer’s Disease, 18, 1130. https://doi.org/10.3233/JAD-2009-1120 CrossRefGoogle ScholarPubMed
Mori, E., Mitani, Y., & Yamadori, A. (1985). Usefulness of a Japanese version of the Mini-Mental State Test in neurological patients. Japanese Journal of Neuropsychology, 1, 8290.Google Scholar
Muramatsu, K., Miyaoka, H., Kamijima, K., Muramatsu, Y., Yoshida, M., Otsubo, T., & Gejyo, F. (2007). The patient health questionnaire, Japanese version: validity according to the mini-international neuropsychiatric interview-plus. Psychological Reports, 101, 952960. https://doi.org/10.2466/pr0.101.3.952-960 Google Scholar
Muth, C., Bales, K. L., Hinde, K., Maninger, N., Mendoza, S. P., & Ferrer, E. (2016). Alternative models for small samples in psychological research: applying linear mixed effects models and generalized estimating equations to repeated measures data. Educational and Psychological Measurement, 76, 6487. https://doi.org/10.1177/0013164415580432 CrossRefGoogle ScholarPubMed
Okura, T., Plassman, B. L., Steffens, D. C., Llewellyn, D. J., Potter, G. G., & Langa, K. M. (2011). Neuropsychiatric symptoms and the risk of institutionalization and death: the aging, demographics, and memory study. Journal of the American Geriatric Society, 59, 473481. https://doi.org/10.1111/j.1532-5415.2011.03314.x CrossRefGoogle ScholarPubMed
Orgeta, V., Qazi, A., Spector, A., & Orrell, M. (2015). Psychological treatments for depression and anxiety in dementia and mild cognitive impairment: systematic review and meta-analysis. British Journal of Psychiatry, 207, 293298. https://doi.org/10.1192/bjp.bp.114.148130 CrossRefGoogle ScholarPubMed
Petersen, R. C. (2011). Clinical practice: mild cognitive impairment. The New England Journal of Medicine, 364, 22272734. https://doi.org/10.1056/NEJMcp0910237 CrossRefGoogle ScholarPubMed
Petersen, R. C., Stevens, J. C., Ganguli, M., Tangalos, E. G., Cummings, J. L., & DeKosky, S. T. (2001). Practice parameter: early detection of dementia: mild cognitive impairment (an evidence-based review). Report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology, 56, 11331142. https://doi.org/10.1212/WNL.56.9.1133 CrossRefGoogle Scholar
Porter, V., Buxton, W. G., Fairbanks, L. A., Strickland, T., O’Connor, S.M., Rosenberg-Thompson, S., & Cummings, J. L. (2003). Frequency and characteristics of anxiety amongst patients with Alzheimer’s disease and related dementias. Journal of Neuropsychiatry and Clinical Neurosciences, 15, 180186. https://doi.org/10.1176/jnp.15.2.180 CrossRefGoogle Scholar
Rodríguez-Sánchez, E., Mora-Simón, S., Patino-Alonso, M. C., García-García, R., Escribano-Hernández, A., García-Ortiz, L., Perea-Bartolomé, M. V., & Gómez-Marcos, M. (2011). Prevalence of cognitive impairment in individuals aged over 65 in an urban area: DERIVA study. BMC Neurology, 11, 147. https://doi.org/10.1186/1471-2377-11-147 CrossRefGoogle Scholar
Sheehan, D. V., Lecrubier, Y., Sheehan, K. H., Amorim, P., Janavs, J., Weiller, E., Hergueta, T., Baker, R., & Dunbar, G. (1998). The Mini-International Neuropsychiatric Interview (M.I.N.I.): the development and validation of a structured diagnostic psychiatric interview for DSM-IV and ICD-10. Journal of Clinical Psychiatry, 59, 2233.Google ScholarPubMed
Sheikh, J., I., & Yesavage, J. A. (1986). Geriatric Depression Scale (GDS): recent evidence and development of a shorter version. Clinical Gerontologist, 5, 65173. https://doi.org/10.1300/J018v05n01_09 Google Scholar
Shin, I. S., Carter, M., Masterman, D., Fairbanks, L., & Cummings, J. L. (2005). Neuropsychiatric symptoms and quality of life in Alzheimer disease. American Journal of Geriatric Psychiatry, 13, 469474. https://doi.org/10.1097/00019442-200506000-00005 CrossRefGoogle ScholarPubMed
Singh-Manoux, A., Dugravot, A., Fournier, A., Abell, J., Ebmeier, K., Kivimaki, M., & Sabia, S. (2017). Trajectories of depressive symptoms before diagnosis of dementia: a 28-year follow-up study. JAMA Psychiatry, 74, 712718. https://doi.org/10.1001/jamapsychiatry.2017.0660 CrossRefGoogle ScholarPubMed
Solfrizzi, V., D’Introno, A., Colacicco, A. M., Capurso, C., Del Parigi, A., & Caselli, R. J. (2007). Incident occurrence of depressive symptoms among patients with mild cognitive impairment-the Italian longitudinal study on aging. Dementia and Geriatric Cognitive Disorders, 24, 5564. https://doi.org/10.1159/000103632 CrossRefGoogle ScholarPubMed
Spector, A., Charlesworth, G., King, M., Lattimer, M., Sadek, S., Marston, L., Rehill, A., Hoe, J., Qazi, A., Knapp, M., & Orrell, M. (2015). Cognitive-behavioural therapy for anxiety in dementia: pilot randomised controlled trial. British Journal of Psychiatry, 206, 509516. https://doi.org/10.1192/bjp.bp.113.140087 CrossRefGoogle ScholarPubMed
Spitzer, R. L., Kroenke, K., & Williams, J. B. W. (1999). Validation and utility of a self-report version of PRIME-MD: the PHQ primary care study. JAMA, 282, 17371744. https://doi.org/10.1001/jama.282.18.1737 CrossRefGoogle ScholarPubMed
Stanley, M. A., Calleo, J., Bush, A. L., Wilson, N., Snow, A. L., Kraus-Schuman, C., Paukert, A. L., Petersen, N. J., Brenes, G. A., Schulz, P. E., & Williams, S. P. (2013). The peaceful mind program: a pilot test of a cognitive-behavioral therapy-based intervention for anxious patients with dementia. American Journal of Geriatric Psychiatry, 21, 696708. https://doi.org/10.1016/j.jagp.2013.01.007 CrossRefGoogle Scholar
Sugishita, K., Sugishita, M., Asada, T., & Tanigawa, T. (2017). A validity and reliability study of the Japanese Version of the Geriatric Depression Scale 15 (GDS-15-J). Clinical Gerontology, 40, 233240. https://doi.org/10.1080/07317115.2016.1199452 CrossRefGoogle ScholarPubMed
Tachimori, H., & Ito, H. (1999). Nihongoban Client Satisfaction Questionnaire 8-koumokuban no shinraisei oyobi datousei no kentou [Reliability and validity of the Japanese version of Client Satisfaction Questionnaire]. Clinical Psychiatry, 41, 711717.Google Scholar
Teri, L., Logsdon, R. G., Uomoto, J., & McCurry, S. M. (1997). Behavioral treatment of depression in dementia patients: a controlled clinical trial. Journals of Gerontology: Psychological Sciences and Social Sciences, 52, P159166. https://doi.org/10.1093/geronb/52B.4.P159 CrossRefGoogle ScholarPubMed
World Medical Association (2013). Declaration of Helsinki – Ethical Principles for Medical Research Involving Human Subjects. Available at: http://dl.med.or.jp/dl-med/wma/helsinki2013e.pdf Google Scholar
Wu, Z., Xm, Zhong, Peng, Q., Chen, B., Zhang, M., Zhou, H., Mai, N., Huang, X., & Ning, Y. (2021). Longitudinal association between cognition and depression in patients with late-life depression: a cross-lagged design study. Frontiers in Psychiatry, 12, 577058. https://doi.org/10.3389/fpsyt.2021.577058 CrossRefGoogle ScholarPubMed
Zarit, S. H., Reever, K. E., & Bach-Peterson, J. (1980). Relatives of the impaired elderly: correlates of feelings of burden. The Gerontologist, 20, 649655. https://doi.org/10.1093/geront/20.6.649 CrossRefGoogle ScholarPubMed
Zarit, S. H., & Zarit, J. M. (1990). The Memory and Behavior Problems Checklist and the Burden Interview. Gerontology Center.Google Scholar
Zigmond, A. S., & Snaith, R. P. (1983). The hospital anxiety and depression scale. Acta Psychiatrica Scandinavica, 67, 361370. https://doi.org/10.1111/j.1600-0447.1983.tb09716.x CrossRefGoogle ScholarPubMed
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