Cognitive Behavioural therapy (CBT) for anxiety in dementia: a pilot randomised controlled trial

Background Anxiety is common and problematic in dementia, yet there lacks effective treatments. Aims To develop a CBT manual for anxiety in dementia, and determine its feasibility through an RCT. Methods A ten session CBT manual was developed following literature search, expert consultation, consensus conference and field testing. Fifty participants with dementia and anxiety (and their carer) were randomly allocated to CBT plus treatment as usual (TAU) (n=25) or TAU (n=25). Outcome and cost measures were administered at baseline, 15 weeks and 6 months. Results At 15 weeks, there was an adjusted difference in anxiety (using the RAID) of (-3.10; 95% CI -6.55, 0.34) for CBT compared to TAU, which fell short of statistical significance. There were significant improvements in depression at 15 weeks after adjustment (-5.37; 95% CI - 9.50, -1.25). Improvements remained significant at six months. CBT was cost neutral. Conclusions CBT was feasible (in terms of recruitment, acceptability and attrition) and effective. A fully powered RCT is now required.