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Online MBCT vs HEP for Depressive Symptoms in Older Adults: RCT

Older Age; Depression

In Canada, depression affects more than 300,000 adults over the age of 60, which costs the healthcare system an estimated $5 billion each year. Late-life depression (LLD) is associated with more deaths, more physical and mental health problems. LLD is hard to treat, as many people will not respond to treatment and many will stop taking antidepressant medication due to negative side-effects. Unfortunately, common non-medication treatments like cognitive behavioral therapy are often inaccessible because of long (6-12 months) wait times and high costs. In a previous study, we found that an 8-week group mindfulness-based cognitive therapy (MBCT) program improved depressive symptoms more than regular LLD treatment (i.e. antidepressants and/or support counseling). Now, a larger scale study is required to compare MBCT to an active control group. Furthermore, research and clinical experience during and post-Covid pandemic has shown that older adults are nowadays far less likely to participate in in-person intervention studies but appreciate and tolerate Zoom delivery of behavioral interventions. This study will compare the effects of MBCT versus an active control group, Health Enhancement Program (HEP), both delivered by Zoom, to see if it improves symptoms of depression in older adults. The study team plans to recruit approximately 100-120 participants in across Canada, who will be randomly assigned to 8-weeks of either MBCT or HEP, delivered by Zoom. The investigators will observe if these treatments improve depression as well as cognition by conducting in-person cognitive assessments. Currently there is a lack of affordable and accessible non-medication treatments for LLD that can be scaled to reach many people. If successful, Mindfulness may be a potential solution, as it is easily given in groups and is well-tolerated by older adults with LLD.

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Participation Requirements

  • Sex:

    ALL

  • Eligible Ages:

    60 and up

Participation Criteria

Inclusion Criteria:

* Ability to provide informed consent (shown as to be able to explain back to the research assistant the purpose of the study as well as voluntary participation, rights, time commitments, etc.)
* MADRS score ≥ 10 (experiencing symptoms of moderate/severe depression) at baseline.
* Participants who have access to internet and basic digital skills to use their computer/tablet. -- Willing and able to attend ≥75% of MBCT or HEP sessions.
* Adequate understanding of English or French.
* Ability to sit for 90 minutes without discomfort.
* Willing to inform if any change is made to their psychotropic medications and dosage for the first 8 weeks of the study

Exclusion Criteria:

* cognitive deficits at baseline, as defined by T-MoCA score \<19.
* diagnosis of post-traumatic stress disorder, bipolar I or II disorder, primary psychotic disorder (e.g. schizophrenia, schizoaffective disorder), and/or severe personality disorder interfering with ability to function in a group setting intervention on a regular basis.
* substance abuse within the past 6 months.
* high suicide risk (e.g., active suicidal ideation and/or recent intent or plan).
* significant visual or hearing impairment
* significant impairments in fine motor skills.
* any medical illnesses that could prevent the participant from engaging in the intervention.
* history of psychiatric hospitalization in the last 3 months

Study Location

Douglas Mental Health University Institute
Douglas Mental Health University Institute
Verdun, Quebec
Canada

Contact Study Team

Primary Contact

Paola Lavin, MD, MSc

[email protected]
Study Sponsored By
Lady Davis Institute
Participants Required
More Information
Study ID: NCT06189118