Does Cognition Predict Treatment Response and Remission in Psychotherapy for Late-Life Depression?
Open accessAbstract
Objectives To identify cognitive predictors of geriatric depression treatment outcome. Method Older participants completed baseline measures of memory and executive function, health, and baseline and post-treatment Hamilton Depression Scales (HAM-D) in a 12-week trial comparing psychotherapies (problem-solving vs. supportive; N = 46). We examined cognitive predictors to identify treatment responders (i.e., HAM-D scores reduced by ≥50%) and remitters (i.e., post-treatment HAM-D score ≤10). Results Empirically derived decision trees identified poorer performance on switching (i.e., Trails B), with a cut-score of ≥82 predicting psychotherapy responders. No other cognitive or health variables predicted psychotherapy outcomes in the decision trees. Conclusions Psychotherapies that support or improve the executive skill of switching may augment treatment response for older patients exhibiting executive dysfunction in depression. If replicated, Trails B has potential as a brief cognitive tool for clinical decision-making in geriatric depression.
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In individuals with late-life depression, participants with relatively lower executive functioning showed greater reductions in depressive symptoms compared with those with relatively higher executive functioning during a CBT intervention.
“Specifically, participants with relatively lower executive functioning showed greater reductions in depressive symptoms compared with those with relatively higher executive functioning during a CBT intervention.4”
From Neuropsychological Functioning and Treatment Outcomes in Acceptance and Commitment Therapy for Chronic Pain. (2018) · cites this paper as [4]
The Abstract Results report that poorer performance on an executive switching task predicted response to psychotherapy, defined in the Abstract Method as at least a 50% reduction in depression scores. But the trial compared problem-solving and supportive therapy, not CBT; the Discussion mentions CBT only when describing other research. The paper therefore does not establish the claimed comparison of symptom reductions during a CBT intervention. (LLM, conf=0.88)
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- Authors
- Beaudreau, S. A., Rideaux, T., O'Hara, R., & Arean, P.
- Affiliations
- The University of Queensland (AU)
- VA Palo Alto Health Care System (US)
- Venue
- The American Journal of Geriatric Psychiatry
- Publisher
- Elsevier BV
- Published
- 2015-02
- Volume
- 23
- Issue
- 2
- Pages
- 215-219
- ISSN
- 1064-7481 (ISSN-L)
- PMC
- PMC4289644
- OpenAlex
- W2088048828
- Cited by
- 43
- References
- 20
- Citations by year
- 2026: 4 · 2025: 3 · 2024: 2 · 2023: 1 · 2022: 2 · 2021: 5 · 2020: 10 · 2019: 3 · 2018: 6 · 2017: 4 · 2016: 3
- FWCI
- 2.76
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- American Journal of Geriatric Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of Mental Health (MH074717, K24MH074717)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
- Keywords
- geriatric depression, psychotherapy outcome, treatment response, remission, executive function, cognitive shifting, Trail Making Test Part B, memory, supportive therapy, cognitive predictors, clinical decision-making
- MeSH terms
- Aged, Cognition, Decision Trees, Depression, Female, Humans, Male, Memory, Neuropsychological Tests, Predictive Value of Tests, Psychotherapy, Remission Induction, Sensitivity and Specificity, Treatment Outcome, Executive Function
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