Image of Jennifer A. Watt, M.D., Ph.D.
Jennifer A. Watt, M.D., Ph.D.

Non-drug interventions are more effective than drug treatment for reducing symptoms of depression in people with dementia.

That’s according to geriatrician-researchers in Canada, who analyzed studies involving more than 25,000 people with depressive symptoms, but no diagnosis of major depressive disorder. Ten interventions were linked to an equal or greater reduction of symptoms than usual care in these patients:

  • animal therapy,
  • cognitive stimulation, 
  • exercise,
  • cognitive stimulation combined with a cholinesterase inhibitor, 
  • massage and touch therapy, 
  • multidisciplinary care, 
  • occupational therapy, 
  • exercise combined with social interaction and cognitive stimulation, 
  • reminiscence therapy, and
  • psychotherapy combined with reminiscence therapy and environmental modification.

In contrast, no drug treatment alone was found to be more effective than usual care, reported Jennifer A. Watt, M.D., Ph.D., from St. Michael’s Hospital in Toronto. And rankings of the interventions suggest that either a non-drug treatment alone or combined with medication work best to reduce symptoms, she and her colleagues wrote. 

The findings suggest a high probability that people with dementia will find clinically meaningful benefits from non-drug interventions, the authors concluded.

“Our study is important and timely given the growing interest in social prescribing — linking patients with non-drug interventions in their community — as a treatment regimen for mitigating symptoms of depression, loneliness, and social isolation,” Watts wrote. Some of the effective options analyzed (such as cognitive stimulation, exercise, and reminiscence therapy) can be prescribed by clinicians as part of an evidence-based treatment plan for people with dementia and depression, she suggested.

The results build on the study team’s earlier finding that non-drug approaches also reduce symptoms of aggression and agitation in people with dementia.

The study was published in the BMJ.