Depression and Suicidal Ideation During Two Psychosocial Treatments in Older Adults with Major Depression and Dementia

Dimitris N. Kiosses, Paul B. Rosenberg, Amanda McGovern, Pasquale Fonzetti, Hana Zaydens, George S. Alexopoulos

Research output: Contribution to journalArticlepeer-review

25 Scopus citations


Background: Depression is prevalent in dementia and contributes to poor outcomes for patients and their families. Antidepressants have limited efficacy in older adults with major depression and dementia, and psychosocial interventions are under-investigated. Objective: To examine the course, predictors and moderators of depression and suicidal ideation during 12 weeks of homedelivered Problem Adaptation Therapy (PATH) versus Supportive Therapy for Cognitively Impaired Older Adults (ST-CI) in 39 older adults with major depression and dementia. Methods: Thirty-nine older adults with major depression, mild or moderate dementia, and disability participated in a randomized controlled trial that compared the efficacy of PATH versus ST-CI. Depression and suicidal ideation were assessed with Cornell Scale for Depression in Dementia Total Score and Suicide Item. Results: PATH participants had significantly greater reduction in depression than ST-CI participants over 12 weeks of treatment. PATH participants with high social support had the greatest reduction in depression. Both treatments had comparable reduction in suicidal ideation. Conclusion: PATH is more effective in reducing depression in older adults with major depression and dementia compared to ST-CI. These results are clinically significant as antidepressants have limited efficacy in this population. Home-delivered psychosocial treatments may reduce suicidal ideation in this population.

Original languageEnglish (US)
Pages (from-to)453-462
Number of pages10
JournalJournal of Alzheimer's Disease
Issue number2
StatePublished - Sep 9 2015
Externally publishedYes


  • Dementia
  • depression
  • psychosocial interventions
  • social support
  • suicidal ideation

ASJC Scopus subject areas

  • Neuroscience(all)
  • Clinical Psychology
  • Geriatrics and Gerontology
  • Psychiatry and Mental health


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