The effects of ECT on cognitive functioning in the elderly: a review.
BACKGROUND
Electroconvulsive therapy (ECT) as a single course or in maintenance form (M-ECT) is an effective treatment in depressed elderly. However, ECT may have adverse effects on cognition.


OBJECTIVE
To review all studies from 1980-2006 on ECT and cognition in the elderly with a minimum age of 55 years or a mean age of 55 years, and with valid measurements of cognition before and after ECT.


RESULTS
Nine out of the 15 eligible studies were focused exclusively on the elderly. Three studies reported verbal learning- and recall problems post ECT, while three studies found positive effects of ECT on memory, speed of processing and concentration. Global cognitive functioning in patients with cognitive impairment improved in all studies. At follow up, most studies reported improvement of cognitive functions. Learning verbal information and executive functioning were impaired in M-ECT patients whereas global cognition remained stable after M-ECT over a year.


CONCLUSIONS
To date research of ECT on cognitive functioning in the elderly is very limited. Small sample size, lack of controls, use of a single screening instrument and a short follow up period may explain the conflicting results. Given the clinical importance, more extensive research on cognition in elderly treated with ECT is urgently needed.
Tielkes
Caroline E M
CE
Department of Psychiatry, VU University Medical Center, Stichting Buitenamstel Geestgronden, Amsterdam, The Netherlands.
Comijs
Hannie C
HC
Verwijk
Esmée
E
Stek
Max L
ML
D000203:Activities of Daily Living / Q000523:psychology*; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D003071:Cognition / Q000502:physiology; D003072:Cognition Disorders / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D003866:Depressive Disorder / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D004565:Electroconvulsive Therapy / Q000009:adverse effects / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests