Highlights
- •What is the primary question addressed by this study?This study explores the association between baseline cognitive impairment and changes in cognition and depression among geriatric patients undergoing acute course electroconvulsive therapy (ECT).
- •What is the main finding of this study?Baseline impaired global cognitive functioning was associated with improved global cognitive functioning following ECT, while baseline normal cognition was associated with cognitive decline following ECT. Baseline cognitive status was not associated with a differential improvement in depression.
- •What is the meaning of the finding?Baseline impaired global cognitive function should not be viewed as a contraindication to ECT in geriatric patients.
Abstract
Objectives
This study explores the association between baseline impaired global cognitive function
and changes in global cognitive function and depression among geriatric patients undergoing
acute course electroconvulsive therapy (ECT).
Design
Retrospective cohort study.
Setting
Single freestanding psychiatric hospital.
Participants
Patients aged 50 and older receiving ECT.
Interventions
10 ECT treatments.
Measurements
Cognitive assessments with the Montreal Cognitive Assessment (MoCA). Depression assessment
with the Quick Inventory of Depressive Symptomatology Self Report 16 item scale (QIDS).
Results
Baseline and follow-up data were available for 684 patients. On average, patients
with baseline normal cognition (MoCA ≥26; N = 371) had a decrease in MoCA of -1.44±0.26
points over the course of treatment, while those with baseline impaired global cognitive
function (MoCA <26; N = 313) had an increase in MoCA of 1.72±0.25 points. Baseline
cognitive status was not associated with a differential response on the QIDS.
Conclusions
Patients with baseline impaired global cognitive function did not demonstrate a worsening
in cognition following ECT, and baseline global cognitive function was not associated
with a differential change in depression with ECT. These results suggest that impaired
global cognitive function should not be viewed as a contraindication to ECT in geriatric
patients.
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Article info
Publication history
Published online: December 17, 2021
Accepted:
December 11,
2021
Received in revised form:
December 10,
2021
Received:
October 7,
2021
Identification
Copyright
© 2021 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.
ScienceDirect
Access this article on ScienceDirectLinked Article
- Further Evidence Supporting the Utility of ECT for People With Cognitive ImpairmentThe American Journal of Geriatric PsychiatryVol. 30Issue 7
- PreviewThe high efficacy and clinical utility of electroconvulsive therapy (ECT) for people with severe or difficult to treat illness is undisputed. While in western countries, ECT is typically used for the treatment of depression, recent evidence from Asian countries has further indicated high efficacy for the treatment of schizophreniform disorders.1 Neuropsychiatric disorders indicated for ECT, including depression and schizophrenia, are frequently associated with cognitive impairment, which can raise concerns during the treatment decision making process.
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