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electroconvulsive Therapy Shows Promise as Effective Treatment for Elderly Depression
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A new study reveals electroconvulsive therapy (ECT) is not onyl safe for patients aged 85 and older suffering from depression, but may even be more effective in this demographic than in younger individuals. The research, published in june 2025 in The American Journal of Geriatric Psychiatry, suggests increased utilization of ECT could reduce hospitalizations and improve outcomes for a frequently overlooked patient population.
Addressing a Critical Gap in Geriatric Mental Healthcare
For years, the treatment of depression in the oldest-old has been hampered by a lack of robust research and concerns about medication side effects. “We wanted to study people aged 85 years or older because they often have depression but are rarely included in research,” explained a researcher from Örebro University. “Medications are known to cause more side effects in this age group. At the same time, knowledge is lacking about how effective and safe other forms of treatment, such as ECT, are for these patients.” This study aimed to fill that knowledge gap by examining the efficacy and safety of ECT in a cohort of over 500 individuals aged 85 or older.
Critically important Improvements Observed in Patient Outcomes
The registry study compared patients receiving ECT to a similarly sized group of younger patients with depression, as well as a control group of elderly individuals who did not receive ECT. The results were striking. Approximately eight out of ten patients in the ECT group showed betterment, with over half achieving full recovery. Moreover, those who underwent ECT experienced fewer hospital readmissions following treatment compared to their peers who did not.
Side effects were reported as minimal, primarily consisting of temporary confusion or fluctuations in blood pressure. “They also had fewer hospital admissions after treatment than their peers who did not receive ECT. Side effects were relatively few and mainly consisted of temporary confusion or blood pressure effects,” a senior researcher stated. the findings challenge the assumption that advanced age is a barrier to successful mental health treatment.
ECT may Outperform Other Treatments in Older adults
Perhaps most substantially, the research indicates that ECT may be more effective in older patients than in younger ones. This is a crucial finding, given the increased vulnerability of the elderly to medication side effects and the potential for complex interactions with other health conditions. “Advanced age in itself does not appear to be an inhibitor to ECT, and severe mental illness can be treated successfully even in very old age,” the researcher concluded.
Implications for Healthcare Practice
The study’s findings have clear implications for clinical practice.The researchers advocate for increased consideration of ECT as a treatment option for elderly patients, particularly when traditional medications prove ineffective or cause unacceptable side effects. “The results show that ECT should be used more in this age group, especially when medication does not help or causes severe side effects,” a researcher noted. “The study may help to reduce hesitation in healthcare and increase access to effective treatment for the oldest patients.”
This research represents a significant step forward in addressing the frequently enough-overlooked mental health needs of the oldest members of society, offering hope for improved quality of life and reduced suffering.
Source: Arnison, T.,et al. (2025). Electroconvulsive therapy in the oldest-old patients with depression: Response and remission rates, prognostic factors, adverse events and mortality. The American Journal of Geriatric Psychiatry. doi: 10.1016/j.jagp.2025.06.013. Related
