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Associations between psychological therapy outcomes for depression and incidence of dementia

BACKGROUND: Depression is an important, potentially modifiable dementia risk factor. However, it is not known whether effective treatment of depression through psychological therapies is associated with reduced dementia incidence. The aim of this study was to investigate associations between reducti...

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Autores principales: John, Amber, Saunders, Rob, Desai, Roopal, Bell, Georgia, Fearn, Caroline, Buckman, Joshua E. J., Brown, Barbara, Nurock, Shirley, Michael, Stewart, Ware, Paul, Marchant, Natalie L., Aguirre, Elisa, Rio, Miguel, Cooper, Claudia, Pilling, Stephen, Richards, Marcus, Stott, Josh
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cambridge University Press 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10476047/
https://www.ncbi.nlm.nih.gov/pubmed/36106698
http://dx.doi.org/10.1017/S0033291722002537
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author John, Amber
Saunders, Rob
Desai, Roopal
Bell, Georgia
Fearn, Caroline
Buckman, Joshua E. J.
Brown, Barbara
Nurock, Shirley
Michael, Stewart
Ware, Paul
Marchant, Natalie L.
Aguirre, Elisa
Rio, Miguel
Cooper, Claudia
Pilling, Stephen
Richards, Marcus
Stott, Josh
author_facet John, Amber
Saunders, Rob
Desai, Roopal
Bell, Georgia
Fearn, Caroline
Buckman, Joshua E. J.
Brown, Barbara
Nurock, Shirley
Michael, Stewart
Ware, Paul
Marchant, Natalie L.
Aguirre, Elisa
Rio, Miguel
Cooper, Claudia
Pilling, Stephen
Richards, Marcus
Stott, Josh
author_sort John, Amber
collection PubMed
description BACKGROUND: Depression is an important, potentially modifiable dementia risk factor. However, it is not known whether effective treatment of depression through psychological therapies is associated with reduced dementia incidence. The aim of this study was to investigate associations between reduction in depressive symptoms following psychological therapy and the subsequent incidence of dementia. METHODS: National psychological therapy data were linked with hospital records of dementia diagnosis for 119808 people aged 65+. Participants received a course of psychological therapy treatment in Improving Access to Psychological Therapies (IAPT) services between 2012 and 2019. Cox proportional hazards models were run to test associations between improvement in depression following psychological therapy and incidence of dementia diagnosis up to eight years later. RESULTS: Improvements in depression following treatment were associated with reduced rates of dementia diagnosis up to 8 years later (HR = 0.88, 95% CI 0.83–0.94), after adjustment for key covariates. Strongest effects were observed for vascular dementia (HR = 0.86, 95% CI 0.77–0.97) compared with Alzheimer's disease (HR = 0.91, 95% CI 0.83–1.00). CONCLUSIONS: Reliable improvement in depression across psychological therapy was associated with reduced incidence of future dementia. Results are consistent with at least two possibilities. Firstly, psychological interventions to improve symptoms of depression may have the potential to contribute to dementia risk reduction efforts. Secondly, psychological therapies may be less effective in people with underlying dementia pathology or they may be more likely to drop out of therapy (reverse causality). Tackling the under-representation of older people in psychological therapies and optimizing therapy outcomes is an important goal for future research.
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spelling pubmed-104760472023-09-05 Associations between psychological therapy outcomes for depression and incidence of dementia John, Amber Saunders, Rob Desai, Roopal Bell, Georgia Fearn, Caroline Buckman, Joshua E. J. Brown, Barbara Nurock, Shirley Michael, Stewart Ware, Paul Marchant, Natalie L. Aguirre, Elisa Rio, Miguel Cooper, Claudia Pilling, Stephen Richards, Marcus Stott, Josh Psychol Med Original Article BACKGROUND: Depression is an important, potentially modifiable dementia risk factor. However, it is not known whether effective treatment of depression through psychological therapies is associated with reduced dementia incidence. The aim of this study was to investigate associations between reduction in depressive symptoms following psychological therapy and the subsequent incidence of dementia. METHODS: National psychological therapy data were linked with hospital records of dementia diagnosis for 119808 people aged 65+. Participants received a course of psychological therapy treatment in Improving Access to Psychological Therapies (IAPT) services between 2012 and 2019. Cox proportional hazards models were run to test associations between improvement in depression following psychological therapy and incidence of dementia diagnosis up to eight years later. RESULTS: Improvements in depression following treatment were associated with reduced rates of dementia diagnosis up to 8 years later (HR = 0.88, 95% CI 0.83–0.94), after adjustment for key covariates. Strongest effects were observed for vascular dementia (HR = 0.86, 95% CI 0.77–0.97) compared with Alzheimer's disease (HR = 0.91, 95% CI 0.83–1.00). CONCLUSIONS: Reliable improvement in depression across psychological therapy was associated with reduced incidence of future dementia. Results are consistent with at least two possibilities. Firstly, psychological interventions to improve symptoms of depression may have the potential to contribute to dementia risk reduction efforts. Secondly, psychological therapies may be less effective in people with underlying dementia pathology or they may be more likely to drop out of therapy (reverse causality). Tackling the under-representation of older people in psychological therapies and optimizing therapy outcomes is an important goal for future research. Cambridge University Press 2023-08 2022-09-15 /pmc/articles/PMC10476047/ /pubmed/36106698 http://dx.doi.org/10.1017/S0033291722002537 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution and reproduction, provided the original article is properly cited.
spellingShingle Original Article
John, Amber
Saunders, Rob
Desai, Roopal
Bell, Georgia
Fearn, Caroline
Buckman, Joshua E. J.
Brown, Barbara
Nurock, Shirley
Michael, Stewart
Ware, Paul
Marchant, Natalie L.
Aguirre, Elisa
Rio, Miguel
Cooper, Claudia
Pilling, Stephen
Richards, Marcus
Stott, Josh
Associations between psychological therapy outcomes for depression and incidence of dementia
title Associations between psychological therapy outcomes for depression and incidence of dementia
title_full Associations between psychological therapy outcomes for depression and incidence of dementia
title_fullStr Associations between psychological therapy outcomes for depression and incidence of dementia
title_full_unstemmed Associations between psychological therapy outcomes for depression and incidence of dementia
title_short Associations between psychological therapy outcomes for depression and incidence of dementia
title_sort associations between psychological therapy outcomes for depression and incidence of dementia
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10476047/
https://www.ncbi.nlm.nih.gov/pubmed/36106698
http://dx.doi.org/10.1017/S0033291722002537
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