A Meta-Analysis of the Effectiveness of Cognitive-Behavioural Therapies for Late-Life Depression

Headnote

ABSTRACT

A comprehensive meta-analysis was conducted using studies of cognitive-behavioural-therapy-based interventions (CBT-BIs) for late-life depression. Patient characteristics, CBT modality, and other study variables were analyzed using subgroup and metaregression analysis methods. Results showed the collective treatment effect of CBT-BIs for reducing late-life depression to be moderate (g = -0.63) with significant heterogeneity (I² = 66.12%). CBT-BIs were found to be no more effective immediately posttreatment than other psychological treatments, pharmacotherapy, or combination interventions. The data support the notion that CBT is more effective in the long term.

RÉSUMÉ

On a mené une méta-analyse approfondie d'apres des interventions basées sur la thérapie cognitivo-comportementale (IB-TCC) conçues pour le traitement de la dépression à un âge avancé. On analysa les caractéristiques du patient, les modalités de la TCC et d'autres variables de l'étude, en ayant recours à des méthodes d'analyse de sous-groupe et d'analyse de métarégression. Les résultats ont révélé que l'effet du traitement collectif des IB-TCC en vue d'atténuer la dépression en âge avancé était moyen (g = -0,63) et considérablement hétérogene (I² = 66,12 %). On a conclu que les IB-TCC ne se révélaient pas plus efficaces immédiatement après le traitement que les autres types de traitements psychologiques, pharmacothérapeutiques ou que les interventions combinées. Les données semblent indiquer que la TCC est plus efficace à long terme.

In 2015, there were 901 million people over the age of 60 years globally. This age demographic is projected to increase to 1.4 billion by 2030 and to 2.1 billion by 2050 (United Nations Department of Economic and Social Affairs, Population Division, 2015). In older adulthood, depression is common and can have detrimental consequences on quality of life and longevity. Prevalence rates for major depression in late life vary considerably depending on the region, setting, and age group. A meta-analysis of these prevalence rates among community-based elderly populations found pooled prevalence rates of 7.2% (range: 4.6-9.3%) for major depression and 17.1% (range: 4.5-37.4%) for clinically significant depressive symptoms (Luppa et al., 2012). Elderly people living in residential care settings have been found to have higher prevalence rates for major depression ranging from 14% to 42% (Djernes, 2006). In a different meta-analysis of prospective studies, elderly women were found to have an increased risk of depression compared...