ICBT for Depression in Older Adults (ALM)

Linköping University (LiU)

Status: Completed

Conditions: Active Control; Internet Treatment

Treatments: Behavioral: Internet-delivered tailored cognitive behavior therapy

Study type: Interventional

Funder types: Other

Identifiers

NCT05269524

Alm study

Details and patient eligibility

About

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.

Full 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.

Enrollment: 101 patients

Sex: All

Ages: 65+ years old

Volunteers: No Healthy Volunteers

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

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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101 participants in 2 patient groups

Treatment

Experimental group

Description:

Therapist-guided internet treatment.

Treatment:

Behavioral: Internet-delivered tailored cognitive behavior therapy

Attention control

Active Comparator group

Description:

Non-directive supportive contact via email.

Treatment:

Behavioral: Internet-delivered tailored cognitive behavior therapy