Funding has been provided for a team of researchers to explore the potential of online therapy to improve cognitive health in older intensive care unit (ICU) survivors struggling with depression.
Depression affects one-third of patients released from the ICU and is a risk factor for Alzheimer’s disease and related dementias. Researchers believe effective depression treatment could be an impactful tool in the effort to prevent cognitive decline in this at-risk population.
The funding of $3.7 million will be spread across five years to support a randomised clinical trial – called ADEPT-ICU (Attenuating DEPression with Internet CBT to Slow Cognitive Decline in Older ICU Survivors).
The trial will evaluate an internet-based cognitive behavioural therapy (CBT) called Good Days Ahead to determine if it can slow subjective cognitive decline in older ICU survivors with moderate to severe depression.
The five-year award was presented by the National Institutes of Health’s National Institute on Aging and the co-principal investigators are Dr. Wang of the IU School of Medicine and Dr. Stewart of the IU School of Science and a Regenstrief affiliate scientist.
“Given cognitive decline’s significant impact on older ICU survivors, there’s a critical need for innovative and accessible interventions,” said Dr. Khan, a Regenstrief and IU School of Medicine researcher-physician.
“Depression presents a promising target for such treatments.”
“There are very few, if almost no, evidence-based treatments for cognitive impairment and depression in older ICU survivors,” said Dr. Wang, an associate professor of clinical psychiatry at the IU School of Medicine.
“ADEPT-ICU will provide critical information about whether internet-based CBT, a well-established treatment for depression in other populations, could address both depression and cognitive decline in this growing population.”
Good Days Ahead is an evidence-based, therapist-assisted CBT that uses a scalable internet-based platform. The ADEPT-ICU study team will enrol 300 older ICU survivors with moderate to severe depression. To ensure a diverse cohort, at least half of the enrolled patients will identify as Black or Hispanic/Latino or have fewer than 12 years of education. The efficacy of the CBT intervention will be compared to that of an active control.
“This new clinical trial represents team science at work,” said Dr. Stewart.
“It brings together experts in critical care medicine, geriatric psychiatry and clinical health psychology to tackle depression and cognitive decline – common problems in ICU survivors. It also utilises a digital therapeutic, which can help address the shortage of CBT therapists.”
“If the therapy is successful, it could be an efficacious, accessible and scalable approach to reduce the burden of cognitive decline and improve quality of life in older ICU survivors,” added Dr. Khan.
