Talking therapies for anxiety and depression in people affected by dementia: A scoping meta-review.

BACKGROUND: Symptoms of anxiety and depression are common in people affected by dementia (people with dementia and family carers). There are many reviews of psychological interventions to reduce stress and distress in people with dementia and family carers, but little cross-fertilisation with the evidence base underpinning NHS Talking Therapies for anxiety and depression (TTad). OBJECTIVES: To review the psychological intervention literature for people with dementia and their family carers through the lens of TTad, thus providing a bridge between the two literatures. METHODS: We undertook a rapid scoping review of meta-analyses of TTad-recommended therapies used with people with dementia and family carers, including cognitive-behavioural therapies (CBT), behavioural activation, problem-solving, counselling for depression and mindfulness-based cognitive therapy. RESULTS: All meta-analytic reviews of cognitive and behavioural therapies (nine with family carers and a Cochrane review with people with dementia) demonstrated the effectiveness of behavioural activation and CBT-informed interventions in reducing symptoms of depression. Anxiety was less frequently studied, with no positive findings found for people with dementia. Psychoeducation was the most effective approach for anxiety reduction in carers. Evidence from meta-analyses of mindfulness-based interventions (MBIs) for carers showed reduced symptoms of both depression and anxiety. CONCLUSIONS: There are ontological and methodological differences in the literatures underpinning TTad and psychological interventions for people affected by dementia. To improve access to TTad for people with dementia and family carers, changes are required to research methodologies, TTad data collection and approaches to service delivery.