In Japan, there is little evidence about the effect of Cognitive Behavioral Therapy (CBT) for older adults compared to Europe and the United States. The purpose of this study was to develop CBT for older adults with depression which fit in with Japanese culture and research its effectiveness in outpatient care. By randomized clinical trial recruiting, 15 older adults were chosen. All the participants had a diagnosis of Major depression. The participants were randomly allocated to receive either Treatment as usual (TAU) group (n=10) or CBT group (n=5). We assessed the degree of depression before the treatments (baseline), at the 6th week and at the 12th week. Measures used in this study were the Zung Self-Rating Depression Scale (SDS), the Geriatric Depression Scale Japanese version (GDS), and the Montgomery Asberg Rating Scale for Depression -Japanese (MADRS-J).In CBT intervention, the psychoeducation about the typical cognitive characteristics of older adults' depression and the reminiscence based hearing of subjects' compliant were conducted in addition to basic CBT strategy. The results suggested that the score of SDS was significantly decreased in both CBT group and TAU group at 12th week (CBT; SDS baseline M=54.4, 12th week M=40.6, TAU; SDS baseline M= 58.5, 12th week M=46.7). The CBT developed in the present study was effective for improving depressive symptoms. However, the difference between CBT group and TAU group in the score of depression was nonsignificant. The results of GDS and MADRS-J showed the same tendency as SDS(CBT; GDS baseline M=10.8, 12th week M=8.6, MADRS-J baseline M=24.8, 12th week M=11.2, TAU; GDS baseline M=11.4, 12th week M=9.7, MADRS-J baseline M=25.2, 12th week M=10.6). The limitation of this study is that the number of CBT session, which was 6, might have not been enough to get the result which would make the differentiate it from TAU. Since CBT alone was effective for the patients to whom the medication of antidepressant had been stopped, the effectiveness of this treatment has been suggested. Future studies need long-term intervention of CBT in a large number of participants. The UNC Alumni Heart Study started in 1986 with data from college entry in 1964-66. We now have 46 years of postcollege follow-up and 12 waves of data collected during midlife from ages 40-60. The majority of the cohort were born in the 1940s and represent the beginning of the Baby Boom generation. We have a large variety of findings on the role of hostility and other MMPI based personality traits from college which have been shown to predict survival, CHD risk factors and hypertension and NEO Personality data from the decade of the 40s that are associated with behavioral risk indicators and life events.