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'Social prescriptions' may be better than medication for treating depression in dementia patients

Non-drug interventions, like animal therapy and exercise, could be better at treating depression in people with dementia than medication.

Reported in a new study published in the British Medical Journal, the findings could go some way to improving treatment for dementia patients that experience symptoms of depression without ever being formally diagnosed.

The research collected data from 256 studies, which included over 28,000 people with dementia, and compared the effect of so-called 'social prescriptions' with medicinal treatment.

According to the study's findings, social prescription interventions were as, if not more, effective at reducing depressive symptoms as medication in dementia patients without a formal diagnosis of a depressive disorder.

These included animal therapy, cognitive stimulation (e.g. art therapy or games), exercise, massage and touch therapy, and occupational therapy.

A list of non-drug treatments tested in the study
'Social prescription' interventions tested in the study. Source: Watt J, et al. BMJ 2021;372:n532.

According to Jennifer Watt, one of the study authors and assistant professor of medicine at the University of Toronto, the findings oppose what is widely considered as the go-to treatment strategy for dementia patients.

"While non-medication strategies were emphasised as being preferable, I was taught that we often lacked the time and resources to facilitate their implementation.

"There was also a sense that people believed that medications worked better—even though we didn’t really know if this was true since studies comparing medication to non-medication strategies were rare."

The belief in medicinal over non-medicinal treatment causes a major problem for effectively treatment depression in dementia patients says Watt, as medications "are associated with potentially catastrophic side effects."

Of the 50 million people currently living with dementia worldwide, 32% will experience depressive symptoms without ever receiving a formal diagnosis.

Depressive symptoms in people with dementia are linked to worse health outcomes than normal, including a lower quality of life, functional decline, and an increased risk of death.

Effects are felt by caregivers too who not only experience increased distress, but are more likely to be diagnosed with depression themselves.

With these new findings, the hope is to encourage patient-centric treatment decisions, says Watt, helping people with dementia live happier lives.

"Now, when I reach for my prescription pad, I hope to write many more prescriptions for non-medication interventions," says Watt.

"I hope that my co-authors and I have given people with dementia, caregivers, clinicians, and policy makers the best evidence yet to support people’s long held assertions that non-medication strategies work as well or better than medications for reducing symptoms of depression in people with dementia."

To read the full paper, click here. To read the full BMJ opinion piece outlining the study findings, click here.


Written by Marco Ricci

Editor and contributor for Talking Mental Health


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