Long-term neurocognitive functioning after electroconvulsive therapy in patients with late-life depression.

Abstract

There is ongoing concern about the possible negative impact of ECT on neurocognitive functioning in older patients. In this study, we aimed to characterize the long-term cognitive effects of ECT in patients with late-life depression, using an extensive neuropsychological battery. A total of 110 patients aged 55years and older with unipolar depression, referred for ECT were included. The neuropsychological test battery was assessed prior to ECT and 6months after the last ECT session. There were no statistically significant group-level changes from baseline to 6months post-ECT in any of the neuropsychological measurements. Individual differences in cognitive performance were detected using the Reliable Change Index. Patients with late-life depression do not show deleterious cognitive effects 6months following an ECT index course, although there are considerable differences at an individual level. Clinicians should not hesitate to prescribe ECT in older patients, as most of these patients will tolerate the treatment course and a small group will even experience a cognitive enhancement. However, clinicians should be aware that a small group of patients can experience cognitive side-effects. Further study is needed to predict which patients have a higher risk of developing cognitive side-effects.