Key TakeawaysA study found that a range of treatments is as or more effective than drugs at treating depression symptoms in people with dementia.Depression symptoms in people with dementia can be debilitating for patients as well as family members and caregivers.Healthcare providers are increasingly considering non-drug approaches for treating depression and loneliness in patients with dementia.

Key Takeaways

A study found that a range of treatments is as or more effective than drugs at treating depression symptoms in people with dementia.Depression symptoms in people with dementia can be debilitating for patients as well as family members and caregivers.Healthcare providers are increasingly considering non-drug approaches for treating depression and loneliness in patients with dementia.

For patients with dementia struggling with depression, drugs alone may not always be the most effective treatment, according to a new study.

Researchers in Canada reviewed more than 250 studies of depression in people with dementia and found that other non-drug therapies, like occupational therapy and exercise, were just as effective as drugs. The February study was published inThe British Medical Journal.

More than 50 million people worldwide have dementia.

About a third of people with dementia will experience depression symptoms, and 16% will be diagnosed with a depressive disorder.Both drug and non-drug interventions are currently used to treat depression symptoms in people with dementia. Drug therapies can include antidepressants and antipsychotics.

However, there is growing interest in updating the way depression is treated among patients with dementia. Evidence of harm associated with antidepressant use in those with dementia—in the form of falls and fractures—and increased interest in “linking patients with non-drug interventions in their community, as an effective treatment to combat symptoms of depression, loneliness, and isolation, has led to a renaissance for non-drug interventions,” according to the study authors.

What Is Dementia?

“We tried to synthesize [the literature] to help healthcare providers have this conversation with patients and caregivers so that they understand that there are real benefits to these non-medication based treatments,” study authorJennifer A. Watt, MD, PhD, a geriatrician and assistant professor at the University of Toronto, tells Verywell.

What This Means For YouIf your loved one is diagnosed with dementia and is exhibiting symptoms of depression, talk to their healthcare providers about what their treatment options are. Know that drug therapies aren’t the only option, and other forms of treatment are available as well.

What This Means For You

If your loved one is diagnosed with dementia and is exhibiting symptoms of depression, talk to their healthcare providers about what their treatment options are. Know that drug therapies aren’t the only option, and other forms of treatment are available as well.

Dementia and Depression

Alzheimer’s is estimated to account for 60 to 70% of cases of dementia, while other common risk factors for developing dementia include conditions that affect the brain, such as stroke and traumatic brain injury. Long-time alcohol or drug use, history of dementia in the family, depression, and lack of exercise have all been linked to a risk of developing dementia as well.

The changes in cognition that accompany the disorder, ranging from forgetfulness to decreased control of emotions and inability to perform daily tasks, can bring about the onset of depression.

Dementia Support Groups

Symptoms of depression in people with dementia can include:

Although not everyone will fulfill the criteria for a major depressive disorder, the authors write, these symptoms will affect the individual as well as their family, friends, and caregivers. They’re also linked with lower quality of life and increased risk of death, as well as increased distress and depression in caregivers.

Alternative Treatments for Depression Symptoms

For the study, the researchers sought to compare how various drug and non-drug treatments compare with usual care—or what healthcare workers usually provide, from drugs to exercise—at treating depression symptoms. They reviewed 256 studies encompassing 28,483 participants with dementia. While most participants showed depression symptoms, they had not received a depressive disorder diagnosis.

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When comparing the data, researchers found that ten interventions were associated with a greater reduction of symptoms of depression compared to usual care:

The last three were more effective than some drug interventions, while the rest were just as effective.

This study further supports these 10 research-backed interventions, and will hopefully, Watt says, guide healthcare providers in advising their patients. “Based on my experience [as a physician], a lot of patients and caregivers don’t actually realize how well these other interventions work, so they really do need a healthcare provider to have that discussion with them and help them to understand what their options are,” Watt says.

Crying and Calling Out in People With Dementia

One instance showing how these interventions work sticks out in her mind. “I always think of this one example where I had a patient who was on dialysis and they were kind of unsettled,” Watt says. “And I had explained to the caregiver to hold their hand, rub their hand, and that this will likely be very calming for them.” At first, the caregiver seemed a bit taken aback, but eventually saw how this helped the patient. “It could also be with just a simple shoulder or lower back massage in the evenings before going to bed,” Watt adds.

Expanding the Definition of Health Care

All the therapies identified work to relieve depression symptoms in a variety of ways. For massage and touch therapy, Watt says it relaxes and reminds the patient that someone’s there. However, current healthcare systems might not count these therapies as “health care,” which can pose barriers to access.

“I know this is a problem in the U.S. like it is in Canada, [it’s] just the way our healthcare systems are built,” Watt says. “Certain interventions are more easily reimbursed than others.” For example, drugs might count as “healthcare” more than occupational therapy.

The current study could work to inform and update healthcare policies, Watt adds. “Not everybody wants to try medication first,” she says. “Certainly there are some instances where medications are necessary. But if they can, [many] would prefer to try other non-medication-based strategies first, or at least to understand what their options are.”

2 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Watt JA, Goodarzi Z, Veroniki AA, et al.Comparative efficacy of interventions for reducing symptoms of depression in people with dementia: systematic review and network meta-analysis.BMJ. 2021;372:n532. doi:10.1136/bmj.n532World Health Organization.Dementia.

2 Sources

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Watt JA, Goodarzi Z, Veroniki AA, et al.Comparative efficacy of interventions for reducing symptoms of depression in people with dementia: systematic review and network meta-analysis.BMJ. 2021;372:n532. doi:10.1136/bmj.n532World Health Organization.Dementia.

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

Watt JA, Goodarzi Z, Veroniki AA, et al.Comparative efficacy of interventions for reducing symptoms of depression in people with dementia: systematic review and network meta-analysis.BMJ. 2021;372:n532. doi:10.1136/bmj.n532World Health Organization.Dementia.

Watt JA, Goodarzi Z, Veroniki AA, et al.Comparative efficacy of interventions for reducing symptoms of depression in people with dementia: systematic review and network meta-analysis.BMJ. 2021;372:n532. doi:10.1136/bmj.n532

World Health Organization.Dementia.

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