Cognitive-behavioural therapy for anxiety in dementia: pilot randomised controlled trial.

BACKGROUND: Anxiety is common and problematic in dementia, yet there is a lack of effective treatments.

AIMS: To develop a cognitive-behavioural therapy (CBT) manual for anxiety in dementia and determine its feasibility through a randomised controlled trial.

METHOD: A ten-session CBT manual was developed. Participants with dementia and anxiety (and their carers) were randomly allocated to CBT plus treatment as usual (TAU) (n = 25) or TAU (n = 25). Outcome and cost measures were administered at baseline, 15 weeks and 6 months.

RESULTS: At 15 weeks, there was an adjusted difference in anxiety (using the Rating Anxiety in Dementia scale) of (-3.10, 95% CI -6.55 to 0.34) for CBT compared with TAU, which just fell short of statistical significance. There were significant improvements in depression at 15 weeks after adjustment (-5.37, 95% CI -9.50 to -1.25). Improvements remained significant at 6 months. CBT was cost neutral.

CONCLUSIONS: CBT was feasible (in terms of recruitment, acceptability and attrition) and effective. A fully powered RCT is now required.