20 Participants Needed

Engage Therapy for Late-Life Depression with Executive Dysfunction

BR
MS
Overseen ByMatthew S Schurr, MA
Age: 18+
Sex: Any
Trial Phase: Academic
Sponsor: University of Nevada, Las Vegas
No Placebo GroupAll trial participants will receive the active study treatment (no placebo)

Trial Summary

Do I have to stop taking my current medications for the trial?

You can continue taking your current medications as long as the dose has been stable for the past 2 weeks.

What data supports the effectiveness of the treatment Engage for late-life depression with executive dysfunction?

Research on similar treatments, like neuroplasticity-based computerized cognitive remediation (nCCR-GD), shows that targeting executive dysfunction can improve depression symptoms in older adults. This suggests that treatments focusing on executive dysfunction, like Engage, may also be effective for late-life depression.12345

Is Engage Therapy for Late-Life Depression with Executive Dysfunction safe for humans?

The Engage Therapy, also known as Engage & Connect, is a psychotherapy aimed at improving social connectedness and has been described as a simple and scalable intervention. While specific safety data for Engage Therapy is not detailed, similar interventions like neuroplasticity-based computerized cognitive remediation (nCCR-GD) have shown high completion rates and are considered safe, with no significant adverse effects reported in studies.12467

How is Engage Therapy different from other treatments for late-life depression with executive dysfunction?

Engage Therapy is unique because it focuses on improving executive dysfunction (problems with planning, decision-making, and attention) in older adults with depression, which is often not addressed by standard antidepressants. This approach may involve psychosocial interventions that enhance alertness and behavioral function, potentially leading to better outcomes for those who do not respond well to traditional medication.12489

What is the purpose of this trial?

Although there are an increasing number of mental health treatment adaptations for older adults, there are still a number of factors to consider when making these adaptations. Cognitive decline is one such factor that places significant burden on older adults and can interfere with traditional mental health therapies. Engage is a behavioral treatment approach that has shown to be effective in treating late life depression. The investigators are testing the feasibility of Engage as a treatment method for late life depression in older adults with cognitive decline. The objective is to corroborate Engage as an alternative late life depression treatment method for a sub-population of older adults with cognitive decline. Cognitive decline poses a unique mental health treatment barrier that is often over looked in younger populations. With a relatively higher prevalence of cognitive decline in older adulthood, it is imperative that a feasible mental health treatment program that can be effective in the presence of cognitive decline.

Eligibility Criteria

This trial is for English-speaking adults aged 60 or older in the Las Vegas area with mild cognitive impairment and depression, who can travel to UNLV campus. They should score between 18-25 on MoCA and over 5 on GDS-SF without active suicidal thoughts, history of suicide attempts, psychosis, substance abuse disorders, bipolar disorder, intellectual disability or being in psychotherapy.

Inclusion Criteria

I have significant depression symptoms, scoring over 5 on the GDS-SF.
Mild cognitive impairment as evidenced by Scores > 18 and < 25 on the Montreal Cognitive Assessment (MoCA)
Located in Las Vegas or surrounding area
See 2 more

Exclusion Criteria

I am currently in or will start individual psychotherapy soon.
My psychotropic medication dose has been stable for the last 2 weeks.
Currently living in an institutional setting (e.g., assisted living, inpatient, skilled nursing)
See 7 more

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Implementation of the 9-week Engage protocol in older adults with late-life depression and comorbid executive dysfunction and mild cognitive impairment

9 weeks
Weekly sessions

Follow-up

Participants are monitored for safety and effectiveness after treatment

27 weeks
Assessments at Week 36

Treatment Details

Interventions

  • Engage
Trial Overview The Engage program is being tested as a feasible treatment for late-life depression among older adults with cognitive decline. The study aims to confirm if Engage can be an effective therapy option despite the challenges posed by cognitive impairments in this demographic.
Participant Groups
1Treatment groups
Experimental Treatment
Group I: Engage TreatmentExperimental Treatment1 Intervention
The study is a single-arm study. The single-arm will be implementation of the 9-week protocol of Engage in an older adult population with late-life depression and comorbid executive dysfunction and mild cognitive impairment.

Find a Clinic Near You

Who Is Running the Clinical Trial?

University of Nevada, Las Vegas

Lead Sponsor

Trials
81
Recruited
14,700+

Findings from Research

In a randomized controlled trial involving 221 older adults with major depression and executive dysfunction, problem-solving therapy (PST) was found to be more effective than supportive therapy (ST) in reducing disability, particularly in patients with greater cognitive impairment.
The benefits of PST not only improved depressive symptoms but also led to a sustained reduction in disability even after treatment ended, suggesting it could be a valuable alternative for older patients who may not respond well to medication.
Problem-solving therapy and supportive therapy in older adults with major depression and executive dysfunction: effect on disability.Alexopoulos, GS., Raue, PJ., Kiosses, DN., et al.[2021]
The neuroplasticity-based computerized cognitive remediation treatment (nCCR-GD) is as effective as escitalopram in reducing depressive symptoms in treatment-resistant older adults, achieving results in just 4 weeks compared to 12 weeks for escitalopram.
Participants undergoing nCCR-GD showed greater improvements in executive function compared to those treated with escitalopram, suggesting that nCCR-GD may better address cognitive deficits associated with geriatric depression.
Neuroplasticity-based computerized cognitive remediation for treatment-resistant geriatric depression.Morimoto, SS., Wexler, BE., Liu, J., et al.[2022]
Cognitive impairment is common in late-life depression and can significantly affect treatment outcomes, particularly due to executive dysfunction, which impacts overall cognitive performance.
Accurate cognitive assessment is crucial for effective treatment planning, and tailored interventions can improve outcomes based on specific cognitive profiles observed in patients.
Diagnosis and treatment of depression and cognitive impairment in late life.Morimoto, SS., Kanellopoulos, D., Manning, KJ., et al.[2022]

References

Problem-solving therapy and supportive therapy in older adults with major depression and executive dysfunction: effect on disability. [2021]
Neuroplasticity-based computerized cognitive remediation for treatment-resistant geriatric depression. [2022]
Diagnosis and treatment of depression and cognitive impairment in late life. [2022]
Executive Dysfunction Predicts Treatment Response to Neuroplasticity-Based Computerized Cognitive Remediation (nCCR-GD) in Elderly Patients with Major Depression. [2018]
Modifiable predictors of nonresponse to psychotherapies for late-life depression with executive dysfunction: a machine learning approach. [2022]
Improving social reward responsivity and social connectedness in psychotherapies for late-life depression: Engage & Connect as an example. [2023]
Speed of processing training and depression in assisted and independent living: A randomized controlled trial. [2020]
Role of executive function in late-life depression. [2003]
Cognitive outcomes after psychotherapeutic interventions for major depression in older adults with executive dysfunction. [2021]
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