Study: Antidepressant vortioxetine combined with cognitive training may help delay cognitive decline

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Can Phar­ma­co­log­i­cal Aug­men­ta­tion of Cog­ni­tive Train­ing Reme­di­ate Age-Relat­ed Cog­ni­tive Decline? (The Amer­i­can Jour­nal of Psychiatry):

A grad­ual decline of cog­ni­tive func­tion and con­cur­rent loss of brain vol­ume is an expect­ed process even in healthy aging. What if, how­ev­er, this process could be delayed, reversed, or even pre­vent­ed? This ques­tion has become increas­ing­ly rel­e­vant as the aver­age expect­ed lifes­pan ris­es. Indeed, the num­ber of Amer­i­cans over age 65 is expect­ed to more than dou­ble from 40 mil­lion in 2010 to 89 mil­lion in 2050.

One method being active­ly researched for pre­serv­ing cog­ni­tive func­tion in aging is cog­ni­tive train­ing. Briefly, this approach lever­ages three decades of progress in cog­ni­tive neu­ro­science, where func­tion­al MRI (fMRI) and oth­er meth­ods have mapped out the dis­crete neur­al cir­cuits engaged dur­ing spe­cif­ic cog­ni­tive process­es that are elicit­ed by well-estab­lished exper­i­men­tal cog­ni­tive tasks…

In this issue of the Jour­nal, Lenze and col­leagues exam­ine the abil­i­ty of the anti­de­pres­sant vor­tiox­e­tine to aug­ment the cog­ni­tive effects of cog­ni­tive train­ing in adults age 65 or old­er … Based on these ear­li­er find­ings, Lenze et al. hypoth­e­sized that com­bin­ing the drug with cog­ni­tive train­ing would ampli­fy the procog­ni­tive effects of train­ing as well as show ben­e­fits on every­day cog­ni­tive tasks (“real-world” behavior)…The results of the study sug­gest that vor­tiox­e­tine may have a syn­er­gis­tic or addi­tive effect when com­bined with cog­ni­tive train­ing to improve cog­ni­tive per­for­mance in old­er adults who are expe­ri­enc­ing non­patho­log­i­cal age-relat­ed cog­ni­tive decline. The study rep­re­sents the first demon­stra­tion that a drug may enhance and accel­er­ate the effects of cog­ni­tive train­ing in this population.

The Study

Aug­ment­ing Com­put­er­ized Cog­ni­tive Train­ing With Vor­tiox­e­tine for Age-Relat­ed Cog­ni­tive Decline: A Ran­dom­ized Con­trolled Tri­al (The Amer­i­can Jour­nal of Psy­chi­a­try). From the abstract:

  • Meth­ods: After a 2‑week lead-in peri­od of cog­ni­tive train­ing, 100 par­tic­i­pants were ran­dom­ly assigned to receive either vor­tiox­e­tine or place­bo in addi­tion to cog­ni­tive train­ing for 26 weeks. The pri­ma­ry out­come mea­sure was glob­al cog­ni­tive per­for­mance, assessed by the NIH Tool­box Cog­ni­tion Bat­tery Flu­id Cog­ni­tion Com­pos­ite. The sec­ondary out­come mea­sure was func­tion­al cog­ni­tion, assessed by the UCSD Per­for­mance-Based Skills Assess­ment. All par­tic­i­pants received moti­va­tion­al mes­sag­ing and sup­port from study staff to max­i­mize adher­ence to the training.
  • Results: Par­tic­i­pants who received vor­tiox­e­tine with cog­ni­tive train­ing showed a greater increase in glob­al cog­ni­tive per­for­mance com­pared with those who received place­bo with cog­ni­tive train­ing. This sep­a­ra­tion was sig­nif­i­cant at week 12 but not at oth­er assess­ment time points. Both groups showed improve­ment in the sec­ondary out­come mea­sure of func­tion­al cog­ni­tion, with no sig­nif­i­cant dif­fer­ence between groups.
  • Con­clu­sions: Vor­tiox­e­tine may be ben­e­fi­cial for age-relat­ed cog­ni­tive decline when com­bined with cog­ni­tive train­ing. These find­ings pro­vide new treat­ment direc­tions for com­bat­ing cog­ni­tive decline in old­er adults.

The Study in Context: