Benedetta Seccomandi1, Deborah Agbedjro2, Morris Bell3, Richard S E Keefe4, Matcheri Keshavan5, Silvana Galderisi6, Joanna Fiszdon7, Armida Mucci6, Roberto Cavallaro8, Natalia Ojeda9, Javier Peña9, Daniel Müller10, Volker Roder10, Til Wykes11, Matteo Cella11. 1. Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London SE5 8AF, UK. Electronic address: benedetta.seccomandi@kcl.ac.uk. 2. Department of Biostatistics & Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London SE5 8AF, UK. 3. Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA. 4. Department of Psychiatry, Duke University Medical Center, Durham, NC, USA. 5. Department of Psychiatry, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA. 6. Department of Psychiatry, Seconda Universita degli Studi di Napoli, Naples, Italy. 7. Department of Psychology, VA Connecticut Healthcare System, West Haven, CT, USA. 8. Department of Clinical Neurosciences, Scientific Institute San Raffaele, Milan, Italy. 9. Faculty of Psychology and Education, University of Deusto, Bilbao, Spain. 10. University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland. 11. Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London SE5 8AF, UK; South London & Maudsley NHS Foundation Trust, Maudsley Hospital, London SE5 8AZ, UK.
Abstract
BACKGROUND: While Cognitive Remediation (CR) is effective in reducing cognitive and functioning difficulties in people with schizophrenia, there is variability in treatment response. Previous research suggested that participants' age may be a significant moderator of CR response. AIM: To examine the impact of participants' age on CR outcomes. METHOD: Individual participant data were accessed from fourteen CR randomised controlled trials. We tested the moderating effect of participants' age on cognitive and functioning outcomes using multivariate linear models. RESULTS: Data from 1084 people with a diagnosis of schizophrenia were considered. Participants had a mean age of 36.6 years (SD 11), with 11.6 years of education (SD 2.8), and an average duration of illness of 13.5 years (SD 10.7). Multivariate models showed that participants' age, when considered as a continuous variable, was not a significant moderator of treatment effect for cognitive and functioning outcomes. However, when participants were split by median age, younger participants showed higher gains in executive functions following CR compared to older participants (p=0.02). CONCLUSION: These results suggest that participants' age does not moderate most CR outcomes. However, larger age differences may influence the effect of CR on executive function. This may suggest some adaptation of CR practice according to participants' age. These findings inform the CR personalisation agenda.
BACKGROUND: While Cognitive Remediation (CR) is effective in reducing cognitive and functioning difficulties in people with schizophrenia, there is variability in treatment response. Previous research suggested that participants' age may be a significant moderator of CR response. AIM: To examine the impact of participants' age on CR outcomes. METHOD: Individual participant data were accessed from fourteen CR randomised controlled trials. We tested the moderating effect of participants' age on cognitive and functioning outcomes using multivariate linear models. RESULTS: Data from 1084 people with a diagnosis of schizophrenia were considered. Participants had a mean age of 36.6 years (SD 11), with 11.6 years of education (SD 2.8), and an average duration of illness of 13.5 years (SD 10.7). Multivariate models showed that participants' age, when considered as a continuous variable, was not a significant moderator of treatment effect for cognitive and functioning outcomes. However, when participants were split by median age, younger participants showed higher gains in executive functions following CR compared to older participants (p=0.02). CONCLUSION: These results suggest that participants' age does not moderate most CR outcomes. However, larger age differences may influence the effect of CR on executive function. This may suggest some adaptation of CR practice according to participants' age. These findings inform the CR personalisation agenda.
Authors: Alice M Saperstein; C Jean Choi; Carol Jahshan; David A Lynch; Melanie Wall; Michael F Green; Alice Medalia Journal: Schizophr Res Date: 2021-03-23 Impact factor: 4.939
Authors: Philip D Harvey; Marta Bosia; Roberto Cavallaro; Oliver D Howes; René S Kahn; Stefan Leucht; Daniel R Müller; Rafael Penadés; Antonio Vita Journal: Schizophr Res Cogn Date: 2022-03-22