title: Depression and Suicidal Ideation During Two Psychosocial Treatments in Older Adults with Major Depression and Dementia.
abstract: BACKGROUND
  Depression is prevalent in dementia and contributes to poor outcomes for patients and their families. Antidepressants have limited efficacy in older adults with major depression and dementia, and psychosocial interventions are under-investigated.
  
  
  OBJECTIVE
  To examine the course, predictors and moderators of depression and suicidal ideation during 12 weeks of home-delivered Problem Adaptation Therapy (PATH) versus Supportive Therapy for Cognitively Impaired Older Adults (ST-CI) in 39 older adults with major depression and dementia.
  
  
  METHODS
  Thirty-nine older adults with major depression, mild or moderate dementia, and disability participated in a randomized controlled trial that compared the efficacy of PATH versus ST-CI. Depression and suicidal ideation were assessed with Cornell Scale for Depression in Dementia Total Score and Suicide Item.
  
  
  RESULTS
  PATH participants had significantly greater reduction in depression than ST-CI participants over 12 weeks of treatment. PATH participants with high social support had the greatest reduction in depression. Both treatments had comparable reduction in suicidal ideation.
  
  
  CONCLUSIONS
  PATH is more effective in reducing depression in older adults with major depression and dementia compared to ST-CI. These results are clinically significant as antidepressants have limited efficacy in this population. Home-delivered psychosocial treatments may reduce suicidal ideation in this population.
authors.affiliation: Department of Psychiatry, Weill Cornell Institute of Geriatric Psychiatry, Weill Cornell Medical College, White Plains, NY, USA.
authors.forename: Dimitris N
authors.initials: DN
authors.lastname: Kiosses
authors.affiliation: Department of Psychiatry, Johns Hopkins University, Baltimore, Maryland, USA.
authors.forename: Paul B
authors.initials: PB
authors.lastname: Rosenberg
authors.affiliation: Department of Psychiatry, Weill Cornell Institute of Geriatric Psychiatry, Weill Cornell Medical College, White Plains, NY, USA.
authors.forename: Amanda
authors.initials: A
authors.lastname: McGovern
authors.affiliation: Department of Neurology, Weill Cornell Medical College, White Plains, NY, USA.|Memory Evaluation and Treatment Service (METS), Burke Rehabilitation Hospital, White Plains, NY, USA.
authors.forename: Pasquale
authors.initials: P
authors.lastname: Fonzetti
authors.affiliation: Department of Psychiatry, Weill Cornell Institute of Geriatric Psychiatry, Weill Cornell Medical College, White Plains, NY, USA.
authors.forename: Hana
authors.initials: H
authors.lastname: Zaydens
authors.affiliation: Department of Psychiatry, Weill Cornell Institute of Geriatric Psychiatry, Weill Cornell Medical College, White Plains, NY, USA.
authors.forename: George S
authors.initials: GS
authors.lastname: Alexopoulos
mesh_terms: D000369:Aged, 80 and over; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D003704:Dementia / Q000523:psychology / Q000628:therapy*; D003863:Depression / Q000628:therapy; D003865:Major Depressive Disorder / Q000523:psychology / Q000628:therapy*; D006233:Persons with Disabilities / Q000523:psychology; D005260:Female; D006699:Home Care Services; D006801:Humans; D008297:Male; D011569:Psychiatric Status Rating Scales; D012944:Social Support; D059020:Suicidal Ideation; D016896:Treatment Outcome
keywords: Dementia; depression; psychosocial interventions; social support; suicidal ideation