Cognitive therapy for depression in the elderly

The applicability for older patients of cognitive (CT) and cognitive-behavioural (CBT) therapies for depression, now well established for clinical populations aged less than 65 years, was reviewed. Eighteen English language articles published to the end of 1994 were located using Medline, Psychlit and key reference searches. Outcome data from seven studies indicate that CT is clearly more effective than no therapy or placebo, through prediction of success remains uncertain. Several variables may influence outcome. Outcome in younger and older depressives with CT was comparable. Adaptation of cognitive-behavioural techniques for older depressives is described. While these may enhance CT's efficacy with older people, they as yet lack empirical evidence. The review, though limited, concludes that CT is an effective intervention for depression in older people and recommends strategies for further research to enable more accurate targeting of therapy.