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Published Online: 26 March 2020

Augmenting Computerized Cognitive Training With Vortioxetine for Age-Related Cognitive Decline: A Randomized Controlled Trial

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Eric J. Lenze, M.D. [email protected], Angela Stevens, B.A., Jill D. Waring, Ph.D., Vy T. Pham, M.D., Rita Haddad, M.D., Josh Shimony, M.D., J. Philip Miller, A.B., and Christopher R. Bowie, Ph.D.Authors Info & Affiliations
Publication: American Journal of Psychiatry
Volume 177, Number 6
https://doi.org/10.1176/appi.ajp.2019.19050561
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Abstract

Objective:

Age-related cognitive decline, the deterioration in functions such as memory and executive function, is faced by most older adults and affects function and quality of life. No approved treatments exist for age-related cognitive decline. Computerized cognitive training has been shown to provide consistent albeit modest improvements in cognitive function as measured by neuropsychological testing. Vortioxetine, an antidepressant medication, has putative procognitive and proneuroplastic properties and therefore may be able to augment cognitive training. In this placebo-controlled study, the authors tested the cognitive benefits of vortioxetine added to cognitive training for adults age 65 or older with age-related cognitive decline.

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.

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Information & Authors

Information

Published In

Go to American Journal of Psychiatry
Go to American Journal of Psychiatry
American Journal of Psychiatry
Volume 177 • Number 6 • June 01, 2020
Pages: 548 - 555
PubMed: 32212856

History

Received: 30 May 2019
Revision received: 8 November 2019
Accepted: 23 December 2019
Published online: 26 March 2020
Published in print: June 01, 2020

Keywords

  1. Cognitive Decline
  2. Cognitive Training
  3. Antidepressant
  4. Neuroplasticity
  5. Cognitive Interventions
  6. Combination Strategies

Authors

Details

Eric J. Lenze, M.D. [email protected]
Healthy Mind Lab, Department of Psychiatry (Lenze, Stevens, Pham, Haddad), Department of Radiology (Shimony), and Division of Biostatistics (Miller), Washington University School of Medicine, St. Louis; Department of Psychology, St. Louis University, St. Louis (Waring); and Department of Psychology, Queen’s University, Kingston, Ontario (Bowie).
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Angela Stevens, B.A.
Healthy Mind Lab, Department of Psychiatry (Lenze, Stevens, Pham, Haddad), Department of Radiology (Shimony), and Division of Biostatistics (Miller), Washington University School of Medicine, St. Louis; Department of Psychology, St. Louis University, St. Louis (Waring); and Department of Psychology, Queen’s University, Kingston, Ontario (Bowie).
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Jill D. Waring, Ph.D.
Healthy Mind Lab, Department of Psychiatry (Lenze, Stevens, Pham, Haddad), Department of Radiology (Shimony), and Division of Biostatistics (Miller), Washington University School of Medicine, St. Louis; Department of Psychology, St. Louis University, St. Louis (Waring); and Department of Psychology, Queen’s University, Kingston, Ontario (Bowie).
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Vy T. Pham, M.D.
Healthy Mind Lab, Department of Psychiatry (Lenze, Stevens, Pham, Haddad), Department of Radiology (Shimony), and Division of Biostatistics (Miller), Washington University School of Medicine, St. Louis; Department of Psychology, St. Louis University, St. Louis (Waring); and Department of Psychology, Queen’s University, Kingston, Ontario (Bowie).
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Rita Haddad, M.D.
Healthy Mind Lab, Department of Psychiatry (Lenze, Stevens, Pham, Haddad), Department of Radiology (Shimony), and Division of Biostatistics (Miller), Washington University School of Medicine, St. Louis; Department of Psychology, St. Louis University, St. Louis (Waring); and Department of Psychology, Queen’s University, Kingston, Ontario (Bowie).
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Josh Shimony, M.D.
Healthy Mind Lab, Department of Psychiatry (Lenze, Stevens, Pham, Haddad), Department of Radiology (Shimony), and Division of Biostatistics (Miller), Washington University School of Medicine, St. Louis; Department of Psychology, St. Louis University, St. Louis (Waring); and Department of Psychology, Queen’s University, Kingston, Ontario (Bowie).
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J. Philip Miller, A.B.
Healthy Mind Lab, Department of Psychiatry (Lenze, Stevens, Pham, Haddad), Department of Radiology (Shimony), and Division of Biostatistics (Miller), Washington University School of Medicine, St. Louis; Department of Psychology, St. Louis University, St. Louis (Waring); and Department of Psychology, Queen’s University, Kingston, Ontario (Bowie).
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Christopher R. Bowie, Ph.D.
Healthy Mind Lab, Department of Psychiatry (Lenze, Stevens, Pham, Haddad), Department of Radiology (Shimony), and Division of Biostatistics (Miller), Washington University School of Medicine, St. Louis; Department of Psychology, St. Louis University, St. Louis (Waring); and Department of Psychology, Queen’s University, Kingston, Ontario (Bowie).
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Notes

Send correspondence to Dr. Lenze ([email protected]).

Funding Information

Supported in part by an investigator-initiated grant from Takeda and Lundbeck, with additional funding from NIH grant R01 AG049689, NIH National Center for Advancing Translational Sciences award UL1TR002345, the Taylor Family Institute for Innovative Psychiatric Research, and the Center for Brain Research in Mood Disorders at Washington University.Dr. Lenze has received grant support from Takeda and Lundbeck (this study), Acadia (through Washington University’s Center for Clinical Studies), Alkermes, Aptinyx, Janssen, Magstim, the McKnight Brain Research Foundation, the Patient-Centered Outcomes Research Institute, and Washington University School of Medicine, and he has served as a consultant for Janssen and Jazz Pharmaceuticals. Dr. Bowie has received grant support from Lundbeck, Pfizer, and Takeda and in-kind research support from Scientific Brain Training; he has served as a consultant for Boehringer Ingelheim, Lundbeck, and Pfizer; and he receives royalties from Oxford University Press. The other authors report no financial relationships with commercial interests.

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