Authors: Ayda Rostamzadeh, Anna Kahlert, Franziska Kalthegener, Frank Jessen
Published: 2020-12-07
DOI: 10.1002/alz.047269
Source: Full article
AbstractBackgroundExpanding technologies of early detection of Alzheimer’s disease (AD) allow to identify individuals at‐risk in very early and asymptomatic disease stages. Neuropsychiatric symptoms, such as anxiety and depression, are common in in the course of AD and may be clinically observed many years before the onset of significant cognitive symptoms. To date, therapeutic interventions for AD focus on pharmacological and non‐pharmacological strategies. However, despite good evidence for psychotherapy in late‐life depression, evidence for such therapeutic options in the course of cognitive decline related to AD is sparse.MethodA systematic review was conducted in PUBMED, PsycINFO and Web of Science to summarize the state of evidence on psychotherapeutic‐psychoeducational interventions for individuals at‐risk for Alzheimer’s dementia. Eligible articles needed to apply a manualized and standardized psychotherapeutic or psychotherapeutic‐psychoeducational intervention administered by trained professionals for individuals with subjective cognitive decline (SCD) or mild cognitive impairment (MCI).ResultThe literature search yielded 35 studies that were included in this narrative summery. The data illustrates heterogeneous therapeutic approaches with mostly small sample sizes of study participants and short follow‐up monitoring. There is evidence that interventions have an antidepressive effect and a positive impact on disease acceptance, including positive effects on life quality. However, specific therapeutic determinants of efficacy have not been identified to date.ConclusionThis review underlines the need of specific psychotherapeutic‐psychoeducational therapeutic approaches for individuals at‐risk of Alzheimer’s dementia, particularly in terms of early interventions aiming at improving well‐being, mental health and quality of life in the course of the neurodegenerative disease. One paramount challenge is the modification of psychotherapeutic techniques according to the different stages of cognitive decline in the course of AD, which is needed to be sensitive to the individual needs and preferences.