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The Effects of Behavioral Therapy on Alzheimer's
Written by Alissa Sauer
about the author
4 minute readLast updated April 20, 2023
A new study has concluded that behavioral therapy may be more effective in treating symptoms of Alzheimer’s disease than commonly prescribed antipsychotic medications. While many seniors may have been prescribed medications to manage the symptoms of Alzheimer’s, therapy is proving to be a safer and more effective way to manage symptoms. Learn more about the study, the benefits of behavioral therapy, and the risks of antipsychotic medication for people with Alzheimer’s.
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Antipsychotic medication vs. behavioral therapy
As most Alzheimer’s caregivers know, the disease is more than just losing memory. Aggressive behaviors, agitation and anxiety are a few of the symptoms that affect many people with the disease. These symptoms are most commonly treated with antipsychotic drugs. In fact, according to a recent report from the Government Accountability Office, 33% of people with Alzheimer’s in nursing homes are prescribed antipsychotic medication. A study published in the British Medical Journal challenged the widespread use of antipsychotic medication for Alzheimer’s by concluding that antipsychotics are less effective than non-drug treatments when it comes to managing symptoms of the disease. Researchers observed over 20 years of studies and concluded that Alzheimer’s symptoms were best managed when caregivers were properly trained on how to communicate with and engage the person living with the disease. While acknowledging that medication can be necessary for emergency situations, they found that antipsychotics were about half as effective as behavioral therapy techniques and that their use can have deadly side effects that increase over time. The United States Food and Drug Administration (FDA) agrees and has issued a warning cautioning that antipsychotics can increase the risk of mortality for people with Alzheimer’s.
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Long-term use of antipsychotics: More common in people with Alzheimer’s
Another study from the University of Eastern Finland has added to the growing body of evidence suggesting that antipsychotic medication may be harmful to people with Alzheimer’s. According to the Finnish Current Care Guidelines, use of antipsychotic medication for people with Alzheimer’s should be a short-term treatment option only for those with severe aggression, agitation or psychotic symptoms. Researchers found that antipsychotic drugs were being used two-three years prior to an Alzheimer’s diagnosis and were most commonly prescribed six months following an official diagnosis. “The study’s results were published in the British Journal of Psychiatry and concluded that 1/3 of people with Alzheimer’s were using antipsychotics, a rate five times higher than the control group, who did not have the disease. Researchers evaluated over 7,200 people with Alzheimer’s using antipsychotics and found that 57% of the participants were using the drugs long-term, for over a year.” The researchers also note that the risk of using antipsychotics could do more harm than good in people with Alzheimer’s. Professor Sirpa Hartikainen cautions that “In Finland, the present incidence of antipsychotic use and the duration of antipsychotic treatment are not in line with the treatment guidelines. This is a cause of concern because the use of antipsychotics increases the risk of severe adverse incidents.”
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Using behavioral therapy as a long-term solution for Alzheimer’s symptoms
Dr. Helen Kales, director of theUniversity of Michigan’s Program for Positive Aging, said of these study results: “Why I think the caregiver interventions work is because they train caregivers to look for the triggers of the symptoms. When [caregivers] see the triggers of the symptoms, they train them to manage them… It’s inherently caregiver and patient-centered.” She also spoke about the risk of mortality associated with antipsychotic drugs, stating that the risk is small over the short term but increases the longer the drug is used. More research into the effects of behavioral therapy on Alzheimer’s is being carried out, specifically on cognitive behavioral therapy (CBT). “CBT is a talking therapy that helps people understand the often missing link between actions, feelings and thoughts, and then use that understanding to make positive changes in their life. Over time, it has become a popular way of helping people cope with mental health problems including anxiety and depression.” Dr. Josh Stott is a researcher from the University College London and is investigating whether this type of therapy could help people in the early stages of the disease, who often struggle with anxiety and depression. He says that CBT would only be helpful for individuals who have Alzheimer’s and anxiety or depression and that it would be more helpful in the early stages of the disease when cognition is not as impaired. While this study is still ongoing, researchers are hopeful that CBT will have positive outcomes for people with Alzheimer’s, helping them to better manage the symptoms that often accompany the disease.
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