title: Cognitive Behavioral Therapies in older adults with depression and cognitive deficits: a systematic review.
abstract: OBJECTIVE
  The objective of this study is to investigate the effectiveness of cognitive behavioral therapies (CBTs) in improving depressive symptoms, disability, and cognition in older adults with depression and cognitive deficits.
  
  
  METHODS
  It was performed a systematic search for articles published between 1994 and February 2014 in the MEDLINE/Pubmed, PsycINFO, and SCIELO. The studies should have provided information about benefits after CBTs to older adults with depression and cognitive deficits.
  
  
  RESULTS
  Cognitive behavioral therapy focused on problem solving is the main approach studied, having better effectiveness than supportive therapy in randomized clinical trials. Significant improvements in mood and disability were consistent, although evidence of changes in cognitive measures is controversial, less studied, and limited. Nevertheless, improvements in executive functions, processing speed, and changes in patients' perspectives of problem solving skills, such as generating alternatives and decision-making, were described. Also, it would be necessary that future studies more often evaluate cognitive status of depressed elders, as well as cognitive changes after psychotherapy. It should be emphasized that there is a lack of studies in this field, and more approaches in CBTs need to be investigated to this population.
  
  
  CONCLUSIONS
  Older adults with depression and cognitive deficits can benefit from CBTs. Improvements in mood and disability are more consistent than changes in cognition, which are little studied after CBTs. It is necessary more studies in the field, as well as, to investigate more approaches in CBTs to older adults with depression and cognitive deficits.
authors.affiliation: Old Age Research Group (PROTER), Institute of Psychiatry, Faculty of Medicine, University of São Paulo, SP, Brazil.
authors.forename: Sharon Sanz
authors.initials: SS
authors.lastname: Simon
authors.forename: Táki Athanássios
authors.initials: TA
authors.lastname: Cordás
authors.forename: Cássio M C
authors.initials: CM
authors.lastname: Bottino
mesh_terms: D000368:Aged; D003072:Cognition Disorders / Q000523:psychology / Q000628:therapy*; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D003866:Depressive Disorder / Q000523:psychology / Q000628:therapy*; D006233:Persons with Disabilities / Q000523:psychology; D056344:Executive Function; D006801:Humans; D011340:Problem Solving
keywords: aging; cognitive behavioral therapy; cognitive deficits; depression; problem solving therapy; psychotherapy