Cognitive Side-effects of Electroconvulsive Therapy in Elderly Depressed Patients

Abstract

Knowledge about cognitive side-effects induced by electroconvulsive therapy (ECT) in depressed elderly patients is sparse. In this study we investigated changes in the cognitive functioning of non-demented elderly depressed patients receiving ECT (n = 62) compared with healthy elderly people (n = 17). Neuropsychological tests were administered at the start of treatment and again within 1 week after treatment. We computed reliable change indices (RCIs) using simple regression methods. RCIs are statistical methods for analyzing change in individuals that have not yet been used in studies of the acute cognitive side-effects of ECT. At the group level, only letter fluency performance was found to be significantly reduced in the ECT group compared with the controls, whereas both groups demonstrated stable or improved performance on all other measures. At the individual level, however, 11% of patients showed retrograde amnesia for public facts post-ECT and 40% of the patients showed a significant decline in neuropsychological functioning. Decline on a measure of delayed verbal anterograde memory was most common. Our findings indicate that there are mild neurocognitive impairments in the acute phase for a substantial minority of elderly patients receiving ECT. Analysis of reliable change facilitated the illumination of cognitive side-effects in our sample.

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

“…Compared with pharmacotherapy, ECT is administered to a higher proportion of elderly patients relative to younger adults (Sackeim, 2005). ECT can cause acute cognitive side effects, including postictal confusion, impaired storing of new memories (anterograde amnesia) and lost memory for information that was gained before ECT (retrograde amnesia) (Dybedal, Tanum, Sundet, Gaarden, & Bjølseth, 2014;Kellner et al, 2010;Kessler et al, 2014). A meta-analysis indicated that anterograde amnesia typically resolves in adult patients within 15 days after ECT (Semkovska & McLoughlin, 2010).…”

Cognitive Effects of Bifrontal Versus Right Unilateral Electroconvulsive Therapy in the Treatment of Major Depression in Elderly Patients

“…The test-retest reliabilities of measures of retrograde amnesia are expected to be high in healthy controls. 40 In a previous study, 36 we report very high test-retest correlations from T1 to T2 on the MQ (Spearman's correlation coefficient of 0.96) in our control group consisting of healthy elderly people (n = 17). Seven (11%) of 61 patients lost more points on the MQ from T1 to T2 than any of the healthy controls.…”

“…36 A psychologist and a trained test assistant conducted the measurements of cognitive functions. General cognitive ability was assessed at the baseline with the Vocabulary subtest from the Wechsler Abbreviated Scale of Intelligence.…”

Unravelling Autobiographical Retrograde Amnesia Following Bitemporal Electroconvulsive Therapy: Effect of Treatment versus Effect of Time

“…Systematic reviews identify autobiographical memory (AM) difficulties as the ECT side-effect that is of most concern to patients (Dybedal et al, 2014;Fraser et al, 2008;Goodman, 2011;Rose et al, 2003). These reviews also agree that, due to the complexity of AM function, reliably measuring its loss following treatment represents a methodological challenge.…”