A review of the cognitive effects of electroconvulsive therapy in older adults.
OBJECTIVE
To review studies that examined the impact of electroconvulsive therapy (ECT) on cognitive functioning in depressed older people.


METHODS
Studies were systematically retrieved using PsychINFO and MEDLINE, with additional articles sourced from lists of references. Given our aged-care focus, study participants had a minimum mean age of 60 years, with no single participant younger than 50 years.


RESULTS
Twenty-seven studies met our criteria. Apart from evidence of interictal slowing of information processing speed, there were mixed results with regard to the impact of ECT on other cognitive domains. Factors contributing to this variability in results include the lack of discrimination between unilateral, bilateral, or mixed electrode placement; the inclusion of patients with dementia; the small sample sizes; and the use of tests insensitive to subtle cognitive changes.


CONCLUSIONS
The effect of ECT in elderly recipients' cognition remains unclear, and further research with more critically selected methods is required. In the meantime, we recommend that clinicians regularly administer brief focused cognitive tests before, during, and after treatment to monitor progress.
Gardner
Betina K
BK
Aged Mental Health Research Unit, Department of Psychological Medicine, Monash University, Victoria, Australia.
O'Connor
Daniel W
DW
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D003072:Cognition Disorders / Q000175:diagnosis / Q000209:etiology*; D004565:Electroconvulsive Therapy / Q000009:adverse effects*; D006801:Humans; D008875:Middle Aged; D009483:Neuropsychological Tests