Is Therapy Appropriate As Cognition Declines?

Cognitive decline is often accompanied by mood disorders, such as anxiety and depression, as well as powerful emotions that can be difficult for the person to understand and manage.

Psychotherapy may be helpful for some people experiencing cognitive decline, and not a good fit for others, says psychiatrist Felipe Jain, MD, director of Healthy Aging Studies at the Depression Clinical and Research Program at Massachusetts General Hospital. It depends on the individual’s needs and preferences, he adds. 

A mental health professional may play an important role in the care of someone experiencing cognitive decline.
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“Psychotherapy may help them clarify their values and preferences in the face of the diagnosis and also work toward acceptance of a condition that cannot be cured but can be faced,” Dr. Jain explains. “Therapy can also help to support them in adjusting their lifestyle to help slow the rate of decline as much as possible. For example, turning off the TV, engaging socially, exercising, and maintaining a healthy diet can all help to slow the rate of decline.”

Several studies have shown that psychological interventions can often ease symptoms of depression and anxiety in people with dementia or mild cognitive impairment (MCI). The use of certain antidepressants for people with dementia may help ease both depressive symptoms and agitation, a common response when a person becomes frustrated or overwhelmed but cannot express those feelings. Antidepressants must be carefully managed, as they can interact with other medications and increase the risk of falls and other complications.

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