Bell, Georgia;
(2023)
Understanding the utility of primary care psychological therapies for risk reduction and therapy outcomes in dementia.
Doctoral thesis (Ph.D), UCL (University College London).
Preview |
Text
PhD Thesis.pdf - Accepted Version Download (1MB) | Preview |
Abstract
Background: Depression and anxiety are associated with dementia risk; however less is known regarding positive mental health. Depression and anxiety are also common in people living with dementia; however the effectiveness of routine primary care psychological therapies for people living with dementia is unknown. Aims: To investigate the utility of Improving Access to Psychological Therapies (IAPT) services for dementia risk reduction and treatment of depression and anxiety in people living with dementia. Specifically, chapter: 2) synthesise evidence for associations between positive psychological constructs (PPCs) with cognitive function, MCI, and dementia, 3) investigate whether PPCs and cognitive function improve pre-post IAPT therapy, 4) investigate differences in IAPT therapy outcomes between people living with dementia and people without dementia, 5) investigate predictors of IAPT therapy outcomes in people living with dementia. Chapter methods: 2) Systematic literature review and meta-analysis. 3) 75 participants aged 60+ without dementia attending IAPT. Explored pre-post therapy change in PPCs, cognition, anxiety, and depression (t tests) and associations between them (linear regression). 4 & 5) Used linked national healthcare records to identify ~1,500 people living with dementia receiving IAPT therapy between 2012 to 2019 and investigated therapy outcomes. Chapter findings: 2) Eudemonic PPCs (purpose/meaning in life) were associated with better cognitive function and reduced risk of dementia. 3) Optimism, memory, and verbal fluency improved over IAPT therapy, but no associations between PPCs and change in cognitive function. 4) Found evidence for IAPT therapies reducing depression/anxiety symptoms in people living with dementia, but poorer outcomes than people without dementia. 5) Predictors of IAPT therapy outcomes in people living with dementia were in-line with those for a general population above and beyond dementia-specific factors. Conclusions: Eudemonic PPCs may be sensible dementia prevention targets, however more work is needed to understand whether existing services (e.g., IAPT) can promote PPCs in older adults. Further, IAPT may be beneficial for people living with dementia, however adaptations (e.g., more therapy sessions) may be required to improve outcomes.
| Type: | Thesis (Doctoral) |
|---|---|
| Qualification: | Ph.D |
| Title: | Understanding the utility of primary care psychological therapies for risk reduction and therapy outcomes in dementia |
| Open access status: | An open access version is available from UCL Discovery |
| Language: | English |
| Additional information: | Copyright © The Author 2023. Original content in this thesis is licensed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0) Licence (https://creativecommons.org/licenses/by-nc/4.0/). Any third-party copyright material present remains the property of its respective owner(s) and is licensed under its existing terms. Access may initially be restricted at the author’s request. |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Div of Psychology and Lang Sciences |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10183407 |
Archive Staff Only
 |
View Item |
