News briefs

Depression in dementia best treated without drugs

Non‐drug therapies, such as exercise, appear to be as or more effective than drugs for reducing symptoms of depression in people with dementia, according to research published in The BMJ. The findings suggest that people with dementia will derive a clinically meaningful benefit from non‐drug interventions, and the researchers say doctors should consider more “social” prescribing of non‐drug approaches to treat symptoms of depression and loneliness. Researchers from the University of Toronto and the University of Calgary analysed the results of existing trials to compare the effectiveness of drug and non‐drug interventions with usual care or any other intervention targeting symptoms of depression in people with dementia. After screening 22 138 records, they reviewed 256 studies involving 28 483 people with dementia, with or without a diagnosed major depressive disorder. Drug approaches alone were no more effective than usual care, but they found ten interventions associated with a greater reduction in symptoms of depression compared with usual care. These were cognitive stimulation, exercise, reminiscence therapy (a treatment to help people with dementia remember events, people and places from their lives), cognitive stimulation with a cholinesterase inhibitor (a drug used to treat dementia), massage and touch therapy, multidisciplinary care, psychotherapy combined with reminiscence therapy and environmental modification, occupational therapy, exercise combined with social interaction and cognitive stimulation, and animal therapy. Three interventions — massage and touch therapy, cognitive stimulation with a cholinesterase inhibitor, and cognitive stimulation combined with exercise and social interaction — were found to be more effective than some drugs.

https://www.bmj.com/content/372/bmj.n532

Loss of trees means more disease

Deforestation, certain types of reforestation and commercial palm plantations correlate with increasing outbreaks of infectious disease, according to research published in Frontiers in Veterinary Science. This study offers a first global look at how changes in forest cover potentially contribute to vector‐borne diseases — such as those carried by mosquitos and ticks — as well as zoonotic diseases, like COVID‐19, which spread from an animal species to humans. The expansion of palm oil plantations in particular corresponded to significant rises in vector‐borne disease infections. The researchers looked at changes in forest cover around the world between 1990 and 2016. They then compared these results to the local population densities and outbreaks of vector‐borne and zoonotic diseases. They also specifically looked at reforestation and afforestation — which included conversion of natural grasslands and abandonment of agricultural land. Several previous studies claimed that both afforestation and palm oil plantations are likely play a role in further spreading disease vectors. Confirming past hypotheses, they found that both deforestation and afforestation had significant correlations to disease outbreaks. They found a strong association between deforestation and epidemics (such as malaria and Ebola) in tropical countries like Brazil, Peru, Bolivia, the Democratic Republic of Congo, Cameroon, Indonesia, Myanmar and Malaysia. In contrast, temperate regions like the US, China and Europe showed clear links between afforestation activities and vector‐borne diseases like Lyme disease. These results suggest that careful forest management is a critical component in preventing future epidemics.

https://www.frontiersin.org/articles/10.3389/fvets.2021.661063/full