Clinical trial NCT05269524: ICBT for Depression in Older Adults
Official title: TAILORED INTERNET-DELIVERED COGNTIVE BEHAVIOR THERAPY FOR DEPRESSED OLDER ADULTS: A RANDOMIZED TRIAL
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Internet Treatment
Active Control
Keywords: depression
Internet-delivered cognitive-behavior therapy
Older adults
Lead sponsor: Linkoeping University
Sponsor class: OTHER_GOV
First posted: 2022-03-08
Enrollment: 101
Sex: ALL
Minimum age (years): 65
Standard ages: OLDER_ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: TREATMENT

Brief summary: 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: 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.

Eligibility criteria: 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

Primary outcomes:
measure: Geriatric Depression Scale (GDS)
timeFrame: Change pre to 10-week post
Secondary outcomes:
measure: Beck Depression Inventory II
timeFrame: Change pre to 10-week post
Other outcomes:
Locations:
city: Linköping
country: Sweden
facility: Department of Behavioral Sciences and Learning, Linköping University
state: Östergötland
Study officials:
References: