Baseline cognitive function does not predict the treatment outcome of electroconvulsive therapy (ECT) in late-life depression

Bjølseth, Tor Magne; Engedal, Knut; Benth, Jūratė Šaltytė; Dybedal, Gro Strømnes; Gaarden, Torfinn Lødøen; Tanum, Lars

doi:10.1016/j.jad.2015.06.021

Cited by 16 publications

(11 citation statements)

References 56 publications

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“…The only difference was found in the general cognitive performance at baseline – excluded patients who performed worse according to MMSE scale. Nevertheless, analysing the available literature on the possible impact of cognitive impairment on ECT, it seems that this variable does not affect the effectiveness or tolerability of ECT treatment 8,39,53,54 . The study by Hausner et al 53 .…”

Section: Discussionmentioning

confidence: 99%

“…6,7 It has also been shown that coexisting cognitive impairments do not affect the effectiveness of ECT. 8 ECT treatments also do not increase the risk of dementia in older patients treated with this method. 9 However, the controversy of ECT for many years now concerns not the efficacy, but the safety and tolerability.…”

Section: Introductionmentioning

confidence: 89%

“…Nevertheless, analysing the available literature on the possible impact of cognitive impairment on ECT, it seems that this variable does not affect the effectiveness or tolerability of ECT treatment. 8,39,53,54 The study by Hausner et al 53 also brought evidence that changes in cognition over the course of ECT did not differ between the groups of patients with initial mild cognitive impairment (MCI) and without cognitive impairment. Although we cannot entirely exclude a bias resulting from the worse cognitive performance of the excluded group, it does not seem that it could significantly impact obtained results.…”

Section: Limitationsmentioning

confidence: 98%

“…ECT has been proven to be an effective method of treatment even in cases of co‐occurrence of somatic diseases, vascular or neurodegenerative lesions in the brain 6,7 . It has also been shown that coexisting cognitive impairments do not affect the effectiveness of ECT 8 . ECT treatments also do not increase the risk of dementia in older patients treated with this method 9 …”

Section: Introductionmentioning

confidence: 99%

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Right unilateral versus bilateral formula‐based electroconvulsive therapy in the treatment of major depression in elderly patients: a randomised, open label, pilot controlled trial

et al. 2021

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Background Electroconvulsive therapy (ECT) remains the most effective treatment of depression in the elderly population; however, it is still unclear which type of ECT is most beneficial in this population. The aims of this study were: (i) to assess the feasibility of a randomised controlled trial in elderly depressed patients treated with right unilateral (RUL) or fronto‐temporal bilateral (BT) formula‐based ECT; (ii) to compare formula‐based RUL and BT ECT in terms of efficacy, safety and tolerability in this population. Methods The study lasted 3 years and managed to randomise 29 patients over 65 years old to receive either BT (n = 14) or RUL (n = 15) ECT. Brief pulse width (0.5 ms) and age‐based dosing method were applied. The clinical efficacy was assessed using Hamilton Depression Rating Scale, somatic state was monitored throughout the ECT course. In neuropsychological examination general cognitive performance, executive functions, verbal fluency, memory, autobiographical memory were evaluated. Results The recruitment was poor due to small number of patients able to give informed consent. ECT proved to be a highly effective and safe method of treatment among elders. Formula‐based RUL ECT did not differ from BT in antidepressant efficacy and had cognitive advantages ‐ the indices of general cognitive performance, verbal fluency and memory were significantly better than before the treatment in the RUL group. Decline in retrieval consistency of autobiographical memory was more pronounced in the BT group, although it was observed across both groups. Conclusions Formula‐based RUL ECT might not differ from BT in antidepressant efficacy and has an advantage in terms of tolerability.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 89%

Section: Limitationsmentioning

confidence: 98%

Section: Introductionmentioning

confidence: 99%

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Right unilateral versus bilateral formula‐based electroconvulsive therapy in the treatment of major depression in elderly patients: a randomised, open label, pilot controlled trial

et al. 2021

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“…Electroconvulsive therapy (ECT) can be an effective course of action, and the presence of cognitive impairment should not preclude its use. A study examining this issue found that baseline cognitive scores were not a predictor of ECT outcomes for elderly people with unipolar or bipolar depression (Bjolseth 2015).…”

Section: How We Might Manage Itmentioning

confidence: 99%

Understanding and managing cognitive impairment in bipolar disorder in older people

2019

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SUMMARYBipolar disorder is less prevalent in older people but accounts for 8–10% of psychiatric admissions. Treating and managing bipolar disorder in older people is challenging because of medical comorbidity. We review the cognitive problems observed in older people, explore why these are important and consider current treatment options. There are very few studies examining the cognitive profiles of older people with bipolar disorder and symptomatic depression and mania, and these show significant impairments in executive function. Most studies have focused on cognitive impairment in euthymic older people: as in euthymic adults of working age, significant impairments are observed in tests of attention, memory and executive function/processing speeds. Screening tests are not always helpful in euthymic older people as the impairment can be relatively subtle, and more in-depth neuropsychological testing may be needed to show impairments. Cognitive impairment may be more pronounced in older people with ‘late-onset’ bipolar disorder than in those with ‘early-onset’ disorder. Strategies to address symptomatic cognitive impairment in older people include assertive treatment of the mood disorder, minimising drugs that can adversely affect cognition, optimising physical healthcare and reducing relapse rates.LEARNING OBJECTIVESAfter reading this article you will be able to: •understand that cognitive impairment in euthymic older people with bipolar disorder is similar to that in working-age adults with the disorder, affecting attention, memory and executive function/processing speeds•recognise that cognitive impairment in older people is likely to be a major determinant of functional outcomes•Implement approaches to treat cognitive impairment in bipolar disorder.DECLARATION OF INTERESTB.J.S. consults for Cambridge Cognition, PEAK (www.peak.net) and Mundipharma.

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Neuromodulation Therapies

Burhan,

Goveas,

Thiab

et al. 2024

Age-Adjusted Psychiatric Treatment for the Older Patient

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Baseline cognitive function does not predict the treatment outcome of electroconvulsive therapy (ECT) in late-life depression

Abstract: How well patients perform on neuropsychological tests at baseline is most likely not a predictor of, or otherwise not significantly associated with the treatment outcome of formula-based ECT in elderly patients with MD.

Cited by 16 publications

References 56 publications

Right unilateral versus bilateral formula‐based electroconvulsive therapy in the treatment of major depression in elderly patients: a randomised, open label, pilot controlled trial

Right unilateral versus bilateral formula‐based electroconvulsive therapy in the treatment of major depression in elderly patients: a randomised, open label, pilot controlled trial

Understanding and managing cognitive impairment in bipolar disorder in older people

Neuromodulation Therapies

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