James Luccarelli1, Brent P Forester2, Mary Dooley3, Regan E Patrick2, David G Harper2, Stephen J Seiner2, Georgios Petrides4, Martina Mueller5, Michael E Henry6. 1. Harvard Medical School (JL, BPF, REP, DGH, SJS, MEH), Boston, MA; Massachusetts General Hospital (JL, MEH), Boston, MA; McLean Hospital (JL, BPF, REP, DGH, SJS), Belmont, MA. Electronic address: jluccarelli@partners.org. 2. Harvard Medical School (JL, BPF, REP, DGH, SJS, MEH), Boston, MA; McLean Hospital (JL, BPF, REP, DGH, SJS), Belmont, MA. 3. College of Health Professions, Medical University of South Carolina (MD), Charleston, SC. 4. Hillside Hospital, Northwell Health, Glen Oaks NY. Zucker School of Medicine with Hofstra/Northwell (GP), Amityville, NY. 5. College of Nursing & Department of Public Health Sciences, Medical University of South Carolina (MM), Charleston, SC. 6. Harvard Medical School (JL, BPF, REP, DGH, SJS, MEH), Boston, MA; Massachusetts General Hospital (JL, MEH), Boston, MA.
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.
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.
Authors: A John Rush; Madhukar H Trivedi; Hicham M Ibrahim; Thomas J Carmody; Bruce Arnow; Daniel N Klein; John C Markowitz; Philip T Ninan; Susan Kornstein; Rachel Manber; Michael E Thase; James H Kocsis; Martin B Keller Journal: Biol Psychiatry Date: 2003-09-01 Impact factor: 13.382