Non-Pharmacological Cognitive Remediation Strategies for Treatment of Depression and Cognitive Impairment

Objective: Major depression in the elderly often presents with cognitive impairment. Mild cognitive deficits in memory, processing speed, and cognitive control functioning are particularly common in late-life depression. For the almost 40% of elderly depressed patients with cognitive impairment, there is currently no efficacious intervention that adequately treats both mood and the cognitive deficits leaving many patients depressed and disabled [AJGP 9(3):269–74, 2001]. Recent Findings: Recent advances in non-pharmacologic treatments for depression and cognitive impairment show promise for treating both cognitive and affective symptoms of the disorder. However, as with any rapid advancements in technology, claims of efficacy may outpace rigorous scientific scrutiny. Purpose of Review: Here, we describe advancements in computerized cognitive remediation (CCR) interventions for depression and cognitive impairment in the elderly. We discuss the parameters of the programs and methods of implementation likely to induce plasticity in the aging brain and suggest critical questions for clinicians, scientists, and patients to evaluate when assessing CCR interventions. Summary: CCR interventions for depression and cognitive impairment show promising though preliminary efficacy. Larger trials that include multiple neurobiological indices of neuroplasticity are necessary to elucidate mechanisms of this novel treatment modality and lead to superior treatments. © 2018, Springer Nature Switzerland AG.