Neurocognitive functioning after electroconvulsive therapy in late‐life depression: a four‐year prospective study

OBJECTIVE Despite the proven efficacy and safety of ECT, there is still concern about the possible cognitive side-effects of ECT in older patients. In this study we aimed to characterize the long-term cognitive effects of ECT in patients with late-life depression (LLD) from before the start until four years after the index ECT course. METHODS 41 patients aged 55 years and older with a unipolar depression, referred for ECT were included. The neuropsychological test battery was assessed prior to ECT, 6 months, 1 year, 2 years, 3 years and 4 years after the last ECT session. RESULTS We did not find any statistically significant cognitive changes from before the start to four years after ending the ECT-course. Although we could not detect cognitive changes at group level, we found clinically important differences on an individual level. CONCLUSION Cognitive performance in patients with LLD run a stable course from before the start of ECT until four years after the index course. At an individual level, however, both cognitive decline and improvement can be witnessed. Older patients can tolerate ECT and most of them will not experience long-term cognitive side-effects.