Telehealth Psychotherapy for Anxiety in Persons With Cognitive Impairment (Tele-CBT)
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Anxiety is a pre-existing mental health issue in older persons with cognitive impairment (includes people with mild cognitive impairment (MCI) and dementia), with considerably high prevalence (14%) as compared to older persons in the general population (3%). Anxiety results in accelerated cognitive decline, increased aggressive behaviours, and even an increased risk of suicide. Anxiety also negatively influences quality of life (QoL) of the individual with cognitive impairment and their care partner, increases early institutionalisation, and amplifies economic burden.
The Tele-CBT package used in this study is a modification of existing manualised psychotherapeutic interventions for treatment of anxiety in people with Parkinson's disease and older adults with cognitive impairment. This new package incorporates techniques tailored to reduce anxiety in people with cognitive impairment, including symptom monitoring. The interventions will include various psychological techniques aimed at reducing anxiety and stress. The intervention consists of 6 weekly psychotherapy sessions. Each therapy session lasts between 30-60 minutes, depending on the participants' capacity to actively participate in session and on their cognitive functioning (e.g. complex attention, executive function). Support persons will be invited and instructed to actively engage in the therapy sessions as well as in between-session home tasks to support the person with cognitive impairment. These techniques will be facilitated via the use of non-immersive videos in telehealth videoconferencing.
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Contact
Study Contact
- Name: Nadeeka Dissanayaka, PhD
- Phone Number: 617 3346 6026
- Email: n.dissanayaka@uq.edu.au
Study Contact Backup
- Name: Tiffany Au, BBiomedSc
- Phone Number: 617 3346 5577
- Email: t.au@uq.edu.au
Study Locations
-
-
Queensland
-
Brisbane, Queensland, Australia, 4072
- The University of Queensland
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
- Child
- Adult
- Older Adult
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Persons with a diagnosis of mild cognitive impairment (MCI) or dementia of any aetiology based on a previous diagnosis by a clinician or scoring above threshold (≤32; MCI ≤32 and dementia ≤27) for cognitive impairment in the Modified Telephone Interview for Cognitive Impairment (TICS-M).
- Persons screening positive for anxiety (scoring ≥9 in the Geriatric Anxiety Inventory, GAI) or reports subjective complaints of anxiety
Exclusion Criteria:
- Persons with severe dementia
- Persons who are unable to communicate or complete questionnaires
- Persons who are at high risk of suicide as identified by by the University of Queensland Suicidal Risk Assessment administered at the UQ Psychology clinic which has been modified for use by the Dementia and Neuro Mental Health Research Unit
- Persons who have major depression as the primary complaint without reported symptoms of anxiety.
- Persons on existing anxiolytics or antidepressants who have not been on a stable dose for at least 12 weeks before starting the trial and are unable to maintain the same dose for the duration of the trial. Changes to medication will be checked at each therapy and assessment session.
- Persons who are undergoing psychological therapy or will undergo psychological therapy over the trial duration.
Entry into the study:
Study entry will be determined by discussions with the core investigator team consisting of clinicians and experienced researchers.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Single
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: Intervention
People who are randomised into the intervention arm will undergo 6 weekly psychotherapy sessions
|
The CBT intervention includes 6 sessions via video-conferencing that has been tailored for people living with cognitive impairment.
The sessions incorporate the use of psychoeducation and relaxation videos to improve home-based practise for long-term outcomes.
|
|
No Intervention: Control
People who are randomised into the control arm will undergo usual care
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Change in anxiety
Time Frame: Post assessment (week 8). Scores ranging between 0 to 54 (lower score indicates better outcomes)
|
Change from baseline in anxiety as measured by the Rating Anxiety in Dementia Scale (RAID).
|
Post assessment (week 8). Scores ranging between 0 to 54 (lower score indicates better outcomes)
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Change in depression
Time Frame: Post assessment (week 8). Scores ranging between 0 to 15 (lower score indicates better outcomes)
|
Change from baseline in depression as measured by the Geriatric Depression Scale (GDS)
|
Post assessment (week 8). Scores ranging between 0 to 15 (lower score indicates better outcomes)
|
|
Change in quality of life
Time Frame: Post assessment (week 8). Scores ranging between 0 to 52 (higher score indicates better outcomes)
|
Change from baseline in quality of life as measured by the Quality of Life in Alzheimer's Disease (QoL-AD)
|
Post assessment (week 8). Scores ranging between 0 to 52 (higher score indicates better outcomes)
|
|
Change in carer burden
Time Frame: Post assessment (week 8). Scores ranging between 0-88 (lower score indicates better outcomes)
|
Change from baseline in carer burden as measured by the Zarit Burden Inventory (ZBI)
|
Post assessment (week 8). Scores ranging between 0-88 (lower score indicates better outcomes)
|
Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Principal Investigator: Nadeeka Dissanayaka, PhD, The University of Queensland
Publications and helpful links
General Publications
- Poon E. A Systematic Review and Meta-Analysis of Dyadic Psychological Interventions for BPSD, Quality of Life and/or Caregiver Burden in Dementia or MCI. Clin Gerontol. 2022 Jul-Sep;45(4):777-797. doi: 10.1080/07317115.2019.1694117. Epub 2019 Nov 22.
- Kuring JK, Mathias JL, Ward L. Prevalence of Depression, Anxiety and PTSD in People with Dementia: a Systematic Review and Meta-Analysis. Neuropsychol Rev. 2018 Dec;28(4):393-416. doi: 10.1007/s11065-018-9396-2. Epub 2018 Dec 7.
- Banks SJ, Raman R, He F, Salmon DP, Ferris S, Aisen P, Cummings J. The Alzheimer's disease cooperative study prevention instrument project: longitudinal outcome of behavioral measures as predictors of cognitive decline. Dement Geriatr Cogn Dis Extra. 2014 Dec 18;4(3):509-16. doi: 10.1159/000357775. eCollection 2014 Sep-Dec.
- Ferretti L, McCurry SM, Logsdon R, Gibbons L, Teri L. Anxiety and Alzheimer's disease. J Geriatr Psychiatry Neurol. 2001 Spring;14(1):52-8. doi: 10.1177/089198870101400111.
- Seyfried LS, Kales HC, Ignacio RV, Conwell Y, Valenstein M. Predictors of suicide in patients with dementia. Alzheimers Dement. 2011 Nov;7(6):567-73. doi: 10.1016/j.jalz.2011.01.006.
- Konnopka A, Konig H. Economic Burden of Anxiety Disorders: A Systematic Review and Meta-Analysis. Pharmacoeconomics. 2020 Jan;38(1):25-37. doi: 10.1007/s40273-019-00849-7.
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- HREC/17/QRBW/676
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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