ICBT for Depression in Older Adults

Study Overview
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Brief Summary
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The study was a randomized controlled trial investigating treatment effects against an active control condition. 101 self-recruited participants, aged 65 to 88 years, were included. The intervention was a 10-week internet-based tailored CBT protocol consisting of 6-10 pre-defined modules tailored to patient profile and preferences. Participants in the treatment group benefitted more than participants in the control condition on almost all measures with moderate between-group effect-sizes.

Detailed Description
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Depression in older adults is associated with poorer functioning, worsened cognitive impairment and disability, as well as medical illnesses. It can also increase the risk of suicide and is associated with a high usage of medical services. It is common that depressive symptoms co-occur with other psychiatric symptoms (i.e. anxiety). In the case of co-morbidity, patients present with greater difficulties and the problems tend to be more persistent. Together this stresses the importance of developing effective treatments. Psychological treatments can be effective but are rarely offered and thus alternative modes of treatment delivery should be considered such as internet interventions. Design: The study was a randomized controlled trial investigating treatment effects against an active control condition. Participants: 101 self-recruited participants, aged 65 to 88 years, were included. Intervention: The intervention was a 10-week internet-based tailored CBT protocol consisting of 6-10 pre-defined modules tailored to patient profile and preferences. Measurements: Depression, anxiety, life quality and cognitive decline were assessed through self-reported measures together with an online test of cognitive flexibility. Results: Participants in the treatment group benefitted more than participants in the control condition on almost all measures with moderate between-group effect-sizes. Cognitive decline improved during treatment and neither cognitive decline, nor cognitive flexibility predicted treatment outcome. Conclusion: The study adds to the evidence of internet-delivered psychological treatment for depression, with or without psychiatric comorbidities, in older adults. It also highlights the possibility of perceived cognitive decline as being part of the clinical picture and reversible, rather than reason for exclusion from for psychological treatment.

Official Title
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TAILORED INTERNET-DELIVERED COGNTIVE BEHAVIOR THERAPY FOR DEPRESSED OLDER ADULTS: A RANDOMIZED TRIAL

Conditions
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Internet Treatment, Active Control

Intervention / Treatment
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* Behavioral: Internet-delivered tailored cognitive behavior therapy


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: age 65 years or older presence of depressive symptoms living in Sweden access to the internet and a computer on a regular basis. Exclusion Criteria: heightened suicidal ideation drug or alcohol abuse or dependency other ongoing psychological treatment severe psychiatric or cognitive problems unstable psychopharmacological medication

Ages Eligible for Study
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Minimum Age: 65 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Treatment<br>Therapist-guided internet treatment. | Behavioral: Internet-delivered tailored cognitive behavior therapy<br>* Therapists-supported tailored 10-week treatment for depression in older adults.<br>* Other names: ICBT;|
| Active Comparator: Attention control<br>Non-directive supportive contact via email. | Behavioral: Internet-delivered tailored cognitive behavior therapy<br>* Therapists-supported tailored 10-week treatment for depression in older adults.<br>* Other names: ICBT;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Geriatric Depression Scale (GDS) | GDS scores range between 0 and 15, and five or less are considered within normal range | Change pre to 10-week post | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Beck Depression Inventory II | For the 21 item BDI-II the maximum score is 63 points and scores below 14 are considered minimal depression. | Change pre to 10-week post | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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depression, Internet-delivered cognitive-behavior therapy, Older adults