Combining Mindfulness-Based Cognitive Therapy With Escitalopram for Cognitive and Emotional Recovery in Older Adults With Treatment-Resistant Depression

OBJECTIVES: This study investigates the adjunctive effects of mindfulness-based cognitive therapy (MBCT) combined with escitalopram hydrobromide on cognitive function and emotional well-being in older adults with treatment-resistant depression (TRD). We hypothesized that this combined approach would lead to greater enhancements in cognitive abilities and overall well-being compared to escitalopram hydrobromide alone in this vulnerable population. METHODS: A total of 230 older adults with TRD and cognitive impairment were randomly assigned into two groups: an experimental group receiving MBCT plus escitalopram (n = 115) and a control group receiving escitalopram alone (n = 115). Cognitive function, depression severity, and quality of life were assessed at baseline, 6 weeks, and 12 weeks using the Montreal Cognitive Assessment (MoCA), Hamilton Depression Rating Scale (HAM-D), and General Quality of Life Index-74 (GQOLI-74). RESULTS: The experimental group demonstrated significant improvements in cognitive function (MoCA scores) and quality of life (GQOLI-74 scores) compared to the control group at both 6 and 12 weeks (p < 0.05). Additionally, depression severity (HAM-D scores) was significantly reduced in the experimental group (p < 0.05). The combined therapy also resulted in higher rates of significant and effective treatment outcomes, with fewer cases of average or ineffective responses (p < 0.05). CONCLUSIONS: The integration of MBCT with escitalopram hydrobromide significantly enhances cognitive function, reduces depressive symptoms, and improves quality of life in older adults with TRD. CLINICAL IMPLICATIONS: Clinicians should consider incorporating mindfulness-based interventions alongside pharmacological treatments for older adults with TRD. TRIAL REGISTRATION: The trial was retrospectively registered with ClinicalTrials. gov (Identifier: NCT07077291).