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Behavioral Activation May Cut Dementia Disparity
JAMA Neurology; ePub 2018 Sep 10; Rovner, et al
Black individuals have almost twice the rate of dementia as white individuals, according to a recent study, and behavioral activation may reduce this health disparity. Participants in this study (n=221) were randomized to behavioral activation, which aimed to increase cognitive, physical, and social activity (111 [50.2%]), or supportive therapy, an attention control treatment (110 [49.8%]). The pre-specified primary outcome was a decline of ≥6 recalled words on the total recall score of the Hopkins Verbal Learning Test–Revised assessed at 6, 12, 18, and 24 months. The secondary outcome was functional decline. Researchers found:
- After baseline, behavioral activation participants engaged in significantly more cognitive activities than supportive therapy participants.
- The 2-year incidence of memory decline was 1.2% for behavioral activation vs 9.3% for supportive therapy.
- Behavioral activation was associated with stable everyday function, whereas supportive therapy was associated with decline.
- Rates of serious adverse events for behavioral activation and supportive therapy, respectively, were: falls (14 [13%] vs 28 [25%]), emergency department visits (24 [22%] vs 24 [22%]), hospitalizations (36 [32%] vs 31 [28%]), and deaths (7 [5%] vs 3 [4%]).
Rovner BW, Casten RJ, Hegel MT, Leiby B. Preventing cognitive decline in black individuals
with mild cognitive impairment. A randomized clinical trial. [Published online ahead of print September 10, 2018]. JAMA Neurology. doi:10.1001/jamaneurol.2018.2513.