Older adults with remitted major depressive disorder showed a slowing of cognitive decline when treated with a combination of cognitive remediation and transcranial direct current stimulation over a median follow-up of nearly four years, according to a recent study.

A randomized clinical trial assessed the efficacy of cognitive remediation (CR) combined with transcranial direct current stimulation (tDCS) in slowing cognitive decline among older adults with remitted major depressive disorder (rMDD) and mild cognitive impairment (MCI). The study enrolled 375 participants aged 60 years and older, with a median follow-up duration of 48.3 months.

Published in JAMA Psychiatry, the results indicated that participants receiving active CR plus tDCS experienced a statistically significant reduction in cognitive decline compared to those receiving sham treatments. At the 60-month follow-up, the adjusted z score difference was 0.21 (95% confidence interval [CI], 0.07 to 0.35; P = .006). The effects were more prominent in the rMDD group, showing improvements in executive function (P = .04) and verbal memory (P = .02). Conversely, the intervention demonstrated a weaker impact on participants with MCI alone, with a hazard ratio for progression to dementia of 0.66 (95% CI, 0.40 to 1.08; P = .10).

These findings indicate that CR and tDCS may be effective in slowing cognitive decline in older adults at risk, particularly those with rMDD. Targeting the prefrontal cortex may influence neuroplasticity, highlighting the need for additional research to assess the long-term effects and interactions between cognitive training and brain stimulation therapies.

Full disclosures can be found in the published study.