Is computerized cognitive-behavioural therapy a treatment option for depression in late-life? A systematic review

Objective. Computerized cognitive-behavioural therapy (CCBT) may enhance older adults access to evidence-based depression treatment. Our objective was to determine the extent to which adults aged 65 years and older are represented in existing studies of CCBT for depression and describe available data on recruitment, retention, and outcomes. Methods. We retrieved all controlled and uncontrolled trials of CCBT for depression published between 2000 and 2010. We obtained data on older adults via the article text or correspondence with authors. Results. Older adults comprised approximately 3% of study participants in reviewed studies. Authors reported that older participants may be less likely than younger adults to drop out, but more likely to experience technical challenges. Conclusions. Older adults are under-represented in studies of CCBT for depression. Practitioner Points CCBT may be a means to help older adults gain access to evidence-based treatment for depression. According to our systematic review, existing studies of CCBT for depression have included very few older participants. Comments by authors of studies suggest that older adults are at least as likely as younger adults to persist with CCBT programs but may be more likely to require technical support. Practitioners should be aware that older adults are increasingly using the Internet for health reasons and may also benefit from Internet-based interventions for depression. A limitation of our study is the fact that older adults who have participated in trials of CCBT for depression may be more comfortable with computer use than older adults in general.