Exercise 'better than medicine' for dementia patients with depression

Therapies such as exercise and social interaction can be as good as or more effective than some medications at treating depression in people with dementia, a study has suggested.

Researchers said their findings could be used by dementia patients and their carers to speak to doctors about available non-drug treatment programmes.

They added that the results could be used to inform clinicians about the option to prescribe non-drug treatment programmes to those with dementia who have symptoms of depression, and said policymakers can “support people with dementia, care givers, and clinicians in choosing non-drug interventions”.

The researchers – based in Canada, Greece and at Imperial College, London – looked at 256 studies, covering 28,483 people with dementia for the paper, published in the BMJ.

They said while individual randomised trials had already shown that non-drug treatment programmes such as exercise could alleviate symptoms of depression in people with dementia, the comparative efficacy of drug and non-drug treatment programmes was not known before their findings.

In the analysis of studies including people with dementia who did not have a diagnosis of a major depressive disorder but who were experiencing symptoms of depression – some 25,177 people – seven treatment programmes were associated with a greater reduction in symptoms of depression compared with usual care.

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These were cognitive stimulation, cognitive stimulation combined with a cholinesterase inhibitor (dementia medicine), massage and touch therapy, multidisciplinary care, occupational therapy, exercise combined with social interaction and cognitive stimulation, and reminiscence therapy.

Massage and touch therapy, cognitive stimulation combined with a cholinesterase inhibitor, and cognitive stimulation combined with exercise and social interaction were “more efficacious than some drug interventions”, they said.

The researchers concluded: “In this systematic review, non-drug interventions were found to be more efficacious than drug interventions for reducing symptoms of depression in people with dementia without a major depressive disorder.”