I would like to know if any one is using TMS to treat Late Life Depression (65+) in patients and if so, what have been the results so far.
Thanks!
Robert
I would like to know if any one is using TMS to treat Late Life Depression (65+) in patients and if so, what have been the results so far.
Thanks!
Robert
@Simcha Cohen I coordinate TMS at a practice that has been treating MDD in older adults for 10+ years. I do not have the resources to review all the older data, but I'd love to provide some data from our 02/2022-07/2024 patients. Averaging the BDI-II scores of our patients ages 65+, the average response rate was a 58.5% decrease in symptoms. This is data from 19 patients, ages 65-79, with BDI-II scores ranging from 0%-97.1%. Hope it helps!
Thanks so much Karissa. This data is very helpful. Are the 65+ patients pleased with the outcome? In other words, did the TMS treatment meet their expecttions? Thanks again!
@Simcha Cohen We have also been treating late life depression for around 6 years. A majority of my older patients with late life depression can tell a difference, a big one is the decrease in brain fog!! Even if their scores are not as low as we hoped, word of mouth from the patient shows me that they are improving and have been satisfied with the results. If I had to make a "guesstimate" about 70% are happy with their results.
Thanks so much Cheyenne! Your "guesstimate" of 70% happy with the results, is a useful metric. Much appreciated!
agree. the most successful responses I have seen are in older patients with a more classic melancholic depression. often they have medical comorbidities and are on lots of meds, so tms makes even more sense as a go to treatment
@Simcha Cohen I would say we have a mix of pleased, neutral, and dissatisfied patients, with the former being the most common and the latter least common. Patients in the 65+ population often have more medical issues that impact their depression, as well as late-life issues, like loss of loved ones and fears about the future. We attempt to gently manage expectations more closely with this patient population and encourage weekly/biweekly psychotherapy. We tend to find the patients who were unsatisfied/did not have a success treatment had external factors/stressors that posed barriers TMS could not help with.
@Simcha Cohen and @Karissa Schilling you may also be interested in this publication :
https://www.brainsway.com/wp-content/uploads/2024/06/jcm-13-00816.pdf
The aim of this phase IV open-label study was to evaluate the safety and efficacy of
Deep TMS in patients with late-life MDD. Data were collected from 247 patients with MDD aged
60–91 at 16 sites who had received at least 20 Deep TMS sessions for MDD.
Following 30 sessions of Deep TMS, there was a 79.4% response and 60.3% remission rate on the
most rated scale.
The outcomes on the PHQ-9 were similar (76.6% response and 54.7% remission rate).
The highest remission and response rates were observed with the HDRS physician-rated scale after 30 sessions (89% response and a 78% remission rate). After 20 sessions, there was a 73% response and 73% remission rate on the HDRS. Consistent with prior studies, the median onset of response was 14 sessions (20 days). The median onset of remission was 15 sessions (23 days). The treatment was well tolerated, with no reported serious adverse events.
These high response and remission rates in patients with treatment-resistant late-life depression suggest that Deep TMS is a safe, well-tolerated and effective treatment for this expanded age range of older adults.
