Virtual assistance for

Anxiety is on the rise. It’s that feeling of dread, distress and despair caused by a significant event or ongoing stress that leaves you vulnerable in unfamiliar territory or unable to cope.

More than one quarter of Australians (26.3 per cent) aged 16-85 years will experience the debilitating effects of anxiety in their lifetime, according to Beyond Blue, which is equivalent to almost five million people today.

The impact of anxiety is extensive, causing accelerated cognitive decline, increased aggressive behaviours and a higher risk of suicide.

Those most at risk are people living with dementia, who are four times more likely to experience anxiety compared to our overall older population. Anxiety reduces quality of life for them and their carers, increases the likelihood of early institutionalisation and amplifies Australia’s economic burden – outcomes that are almost 1.5 times more prevalent in rural areas than major cities.

By 2050, the number of Australians diagnosed with dementia, currently the nation’s second highest cause of death and leading cause of death in women, is expected to rise to more than one million.

Associate Professor Nadeeka Dissanayaka from the UQ Centre for Clinical Research (UQCCR) describes the need to reduce disease progression as imperative.

“Inappropriate chemical restraints to manage anxiety and ongoing social isolation of those living with dementia needs to change rapidly,” Dr Dissanayaka says.

“We need sustainable and accessible interventions so that care doesn’t impede, or worse, stop service delivery like it did for a lot of people during the COVID-19 lockdowns.

“Anxiety treatment for people living with dementia isn’t routinely available, easily accessible or integrated into current primary health care or memory clinics, and the demands on society caused by anxiety are growing.”

Dr Dissanayaka and her team are currently working on an innovative intervention – a national project supported by a recently funded MRFF Dementia, Ageing and Aged Care Mission grant of more than $1.6 million.

“We are developing a digital platform to deliver personalised psychotherapy via video-conferencing, guided by a customised digital assistant voice application,” she explains.

“People with lived experiences of dementia, carers, community members, and industry partners are helping to co-design the platform during the development phase.

“This holistic and scalable tool will help mitigate social isolation for people living with dementia and reduce the burden on carers.”

“CBT has traditionally been delivered as in-person therapy, but there’s now increased interest in delivering this via telehealth videoconferencing to increase outreach and reduce the reliance on carers to drive people living with dementia to treatment appointments.

“Virtual delivery of interventions via telehealth to people’s homes gives people living with dementia a sense of independence and reduces the burden on carers.”

UQCCR researchers will use the platform as part of a study where people living with dementia receive six one-hour sessions of CBT delivered by postgraduate trainees, who are either completing advanced psychology training with UQ and are provisionally registered psychologists with the Psychology Board of Australia or are registered Mental Health Counsellors enrolled in PhD programs with the University.

“We expect the new platform to achieve similar outcomes to in-person treatments,” Dr Dissanayaka reveals.

“UQ has been successfully using postgraduate psychology trainees to deliver interventions in our funded psychotherapy research for more than a decade.

“All therapists are supervised by registered academic psychologists at the UQ School of Psychology or at Queensland Health Psychology departments.

“In this way, we are training the next generation of psychological providers specialised in dementia and increasing the number of specialists available for people living with dementia.”

Dr Dissanayaka knows how valuable this experience is in education.

“I worked in aged care during my undergraduate life and was exposed to chronic health conditions in older people. I witnessed social isolation and related mental health conditions, as well as challenging behaviours and psychological conditions associated with dementia,” she reveals.

“This sparked my interest in understanding brain mechanisms associated with age-related chronic disease and mental health conditions, and developing new treatment strategies.

“I was also motivated by experiences in my native country of Sri Lanka, where people aren’t typically treated for anxiety due to stigma and a lack of understanding.

“It’s important that people experiencing anxiety identify, acknowledge and accept their condition.

“The first step is to talk to somebody, so the condition can be evaluated.”

This story is featured in the Winter 2022 edition of UQmedicine Magazine. View the latest edition here. Or to listen, watch, or read more stories from UQ’s Faculty of Medicine, visit our blog, MayneStream.