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The effect of cognition and age on the efficacy of psychotherapy in late-life depression

Background - Cognitive impairment is prevalent in older age and in patients with depression, which may limit the efficacy of psychotherapy for late-life depression (LLD). We analyzed the effect of age and baseline cognition on the efficacy of psychotherapy in LLD. - Methods - This secondary analysis...

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Main Authors: Bewernick, Bettina (Author) , Buschmann, Julijana (Author) , Heser, Kathrin (Author) , Kleineidam, Luca (Author) , Domschke, Katharina (Author) , Elsaesser, Moritz (Author) , Zehender, Nadine (Author) , Luppa, Melanie (Author) , Hellmich, Martin (Author) , Peters, Oliver (Author) , Frölich, Lutz (Author) , Riedel-Heller, Steffi (Author) , Schramm, Elisabeth (Author) , Hautzinger, Martin (Author) , Jessen, Frank (Author) , Dafsari, Forugh S. (Author) , Wagner, Michael (Author)
Format: Article (Journal)
Language:English
Published: 15 December 2025
In: Journal of affective disorders
Year: 2025, Volume: 391, Pages: 1-8
ISSN:1573-2517
DOI:10.1016/j.jad.2025.119881
Online Access:Verlag, kostenfrei, Volltext: https://doi.org/10.1016/j.jad.2025.119881
Verlag, kostenfrei, Volltext: https://www.sciencedirect.com/science/article/pii/S0165032725013230
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Author Notes:Bettina Bewernick, Julijana Buschmann, Kathrin Heser, Luca Kleineidam, Katharina Domschke, Moritz Elsaesser, Nadine Zehender, Melanie Luppa, Martin Hellmich, Oliver Peters, Lutz Froelich, Steffi Riedel-Heller, Elisabeth Schramm, Martin Hautzinger, Frank Jessen, Forugh S. Dafsari, Michael Wagner
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Summary:Background - Cognitive impairment is prevalent in older age and in patients with depression, which may limit the efficacy of psychotherapy for late-life depression (LLD). We analyzed the effect of age and baseline cognition on the efficacy of psychotherapy in LLD. - Methods - This secondary analysis of a randomized controlled multicenter study included 213 participants (60-92 years) with moderate to severe depression who had received either supportive psychotherapy (SUI) or an LLD-specific cognitive behavioral therapy (LLD-CBT), both of which led to a substantial reduction in depressive symptoms. We examined the influence of age and baseline cognition, assessed with the CERAD-plus neuropsychological battery, on changes in the Geriatric Depression Scale (GDS) at the end of treatment and at 6-month follow-up. Trial registration at ClinicalTrials.gov (NCT03735576) and DRKS (DRKS00013769). - Findings - Baseline cognition was slightly below norms (<1SD), with 15 % of patients meeting criteria for Mild Cognitive Impairment (MCI). GDS change at the end of treatment was not significantly associated with baseline cognition or MCI status, although additional interaction analyses suggest that, in the SUI group, lower baseline cognitive performance was associated with reduced treatment efficacy at follow-up only. Additionally, we found that higher age predicted a smaller reduction in GDS scores both at end-of-treatment and at follow-up in both treatment groups. - Interpretation - Higher age, but not lower cognitive performance, was associated with reduced psychotherapy efficacy. Thus, age-related factors should be considered in psychotherapy.
Item Description:Online verfügbar: 14. Juli 2025, Artikelversion: 23. Juli 2025
Gesehen am 21.08.2025
Physical Description:Online Resource
ISSN:1573-2517
DOI:10.1016/j.jad.2025.119881

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