Management of Late-Life Depression in the Context of Cognitive Impairment: a Review of the Recent Literature

AbstractPurpose of ReviewEvidence regarding the treatment of late-life depression is not necessarily generalizable to persons with a neurocognitive disorder and comorbid depression. Thus, this article reviews recent evidence that pertains to the treatment of depression in older adults with neurocognitive disorders, and synthesizes and critically analyzes this literature to identify methodological issues and gaps for the purpose of future research.Recent FindingsControlled trials and meta-analyses examining depression treatment in neurocognitive disorders, published between 2015 and 2019 (N = 16 reports), can be divided into those addressing pharmacotherapy, psychological and behavioral therapy, and somatic therapy. The evidence generally does not support benefit of antidepressant medication over placebo in treating depressive disorders in dementia. No pharmacological studies sinc e 2015 have examined antidepressant medication in participants with mild cognitive impairment (MCI). Problem adaptation therapy demonstrates efficacy for depression in MCI and mild dementia. Other psychological and behavioral interventions for depressive symptoms in dementia demonstrate mixed findin gs. The only somatic treatment trials published since 2015 have assessed bright light therapy, with positive findings but methodological limitations.SummaryPsychological, behavioral, and somatic treatments represent promising treatment options for depression in neurocognitive disorders, but further st...

Source: Current Psychiatry Reports - July 4, 2019 Category: Psychiatry Source Type: research