ABSTRACT
Anxiety is commonly reported in patients with dementia, resulting in a further decline in functioning. An overview of the clinical application of cognitive-behavioral techniques in treating anxiety in elderly patients with brain damage is presented. Two cases are described with a focus on clinical anxiety management techniques that have been modified to suit cognitively impaired elderly patients. These modifications include simplifying material, using more structured techniques, and recognizing the critical role of the patient's caregiver in therapy. It is concluded that cognitive-behavior therapy can help in reducing anxiety in the demented population; the potential benefits of this therapy are an increase in patients' self-esteem and independence and the prevention of hospitalization.
Subject(s)
Anxiety/therapy , Cognitive Behavioral Therapy , Dementia/therapy , Aged , Aged, 80 and over , Alcoholism/complications , Alcoholism/psychology , Anxiety/etiology , Brain Damage, Chronic/complications , Brain Damage, Chronic/therapy , Caregivers/psychology , Dementia/complications , Family Therapy , Fatal Outcome , Female , Geriatric Assessment , Humans , Male , Relaxation TherapyABSTRACT
Ten patients with probable Alzheimer's disease were assessed at baseline and a mean 2 years later using a battery of neuropsychological tests, CT scans and Tc99m-HMPAO SPECT scans. The subjects had declined significantly in their functional indices. Cerebral perfusion measures declined in the parietal lobes, left hemisphere and whole brain, but the overall decline did not reach statistical significance. The decline in brain perfusion did not correlate significantly with the decline in various indices of neuropsychological function, either globally or for specific brain regions. The index of cerebral perfusion correlated significantly with global indices of neuropsychological function at baseline but not at follow-up. No single perfusion index was a significant predictor of clinical progression of dementia.
