Clinical Outcomes of Electroconvulsive Therapy (ECT) for Depression in Older Old People Relative to Other Age Groups Across the Adult Life Span: A CARE Network Study

ABSTRACT Intervention Electroconvulsive therapy (ECT) is a commonly used treatment for severe psychiatric illness in older adults, including in the ‘older old’ population aged 80 years and above. However, there can sometimes be a reluctance to treat the 80+ year old age group with ECT due to medical...

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Published in:International journal of geriatric psychiatry 2024-08, Vol.39 (8), p.e6133-n/a
Main Authors: Sarma, Shanthi, Zeng, Yucheng, Barreiros, Ana Rita, Dong, Vanessa, Massaneda‐Tuneu, Clara, Cao, Thanh Vinh, Waite, Sue, McCosker, Laura K., Branjerdporn, Grace, Loo, Colleen K., Martin, Donel M.
Format: Article
Language:English
Subjects:
Age groups
Clinical outcomes
Clinical significance
Cognitive ability
cognitive side effects
Comorbidity
ECT
Electroconvulsive therapy
Life span
major depression
Mental depression
older old adults
Remission
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Summary:ABSTRACT Intervention Electroconvulsive therapy (ECT) is a commonly used treatment for severe psychiatric illness in older adults, including in the ‘older old’ population aged 80 years and above. However, there can sometimes be a reluctance to treat the 80+ year old age group with ECT due to medical comorbidities, frailty, and concerns about cognition. Objective, Design, Setting, and Participants This multi‐site, longitudinal Australian study aimed to investigate the effectiveness and safety of ECT in older old people compared with younger age groups. Data from 310 people receiving ECT for depression at three participating hospitals was collected in a naturalistic setting, between 2015 and 2022. Measurements Clinical ratings were conducted pre‐ECT and end‐acute ECT using the Montgomery–Åsberg Depression Rating Scale (MADRS). Cognitive outcomes were assessed using the Montreal Cognitive Assessment (MoCA). Results Older old adults demonstrated a significant reduction MADRS scores at post‐treatment. They were more likely to meet remission criteria compared with the younger age groups. Older old adults were also less likely to show clinically significant cognitive decline post‐ECT, and were more likely to show clinically significant cognitive improvement post‐ECT compared with younger age groups. Conclusions ECT is highly effective in treating severe psychiatric illness in older old adults. Relative to the younger age groups, the older old group were more likely to remit with ECT and a greater proportion showed cognitive improvement post‐ECT. These findings suggest that ECT should be considered as a valuable and safe treatment option for older old individuals with depression.
ISSN:0885-6230
1099-1166
1099-1166
DOI:10.1002/gps.6133