Age-related cognitive effects of ECT and ECT-induced mood improvement in depressive patients

Abstract

This explorative study investigated the interaction between electroconvulsive therapy (ECT) treatment-effect, reduced depression, and neuropsychological outcome in relation to age. Follow-up neuropsychological assessment was conducted with depressive patients treated with ECT. From a potential sample of 45 patients, the neuropsychological measures (pre-ECT, three times post-ECT, up to 12 months) and clinical data from the remaining 21 patients who completed all assessments were evaluated (mean age 5 56.76; SD 5 14.12; range, 33-79). ECT resulted in a decrease in the depression scores. A distinct impact of ECT and depression decrease on cognitive domains was found. Depression alleviation was mainly associated with improvement in cognitive domains such as memory, information processing, and executive function. ECT improved cognitive domains such as information processing and perception. Short-term cognitive improvement was greater in older patients but showed an increase similar to that at long-term follow-up in younger patients (o60). Current findings provide evidence that ECT may improve cognitive functioning in nondemented elderly, which has strong clinical relevance concerning the use of ECT.

The effects of ECT on cognitive functioning in the elderly: a review

“…This short term improvement was more pronounced in older patients compared to younger patients (<60 years). At the same time, decreased inhibition (frontal function) was seen after a course of ECT (Bosboom and Deijen, 2006).…”

“…In general they reported at follow-up (up to 12 months after ECT) for all ages similar improvement of neuropsychological scores. Whereas ECT improved speed of information processing, mental control, memory (all aspects) and perception (visual organization), recovery of depression was especially associated with improvement of memory (verbal learning), higher speed of information processing and improvement of executive functioning (Bosboom and Deijen, 2006).…”

The Role of Baseline Cognitive Function in the Neurocognitive Effects of Electroconvulsive Therapy in Depressed Elderly Patients

“…This result was not consistent with previous findings in which the mean age of the samples was in the 40s and 50s (Sackeim et al, 2007;Sobin et al, 1995). Bosboom and Deijen (2006) found that the alleviation of depression after ECT was associated with a short-term cognitive improvement that was greater in older patients (≥60 years of age). The markedly negative, but transient, effect of major depression on cognition in a subgroup of elderly individuals who later remit from depression may imply that we were less likely to find such associations in our elderly sample.…”

Changes in Everyday and Semantic Memory Function After Electroconvulsive Therapy for Unipolar Depression

“…Another possible explanation is that stimulation of the neural system results in restorative plasticity, especially in the elderly. 15,17 Because with ECT the elderly are at a disadvantage for disturbance of other kinds of memory (such as short-term memory), restorative plasticity may adhere to specific brain regions. 7,18 Only the scores on WF-2 were significantly affected by electrode placement over time.…”