Aging Ment Health. 2025 Apr 25:1-8. doi: 10.1080/13607863.2025.2490997. Online ahead of print.
ABSTRACT
OBJECTIVES: To evaluate the effectiveness of repetitive transcranial magnetic stimulation (rTMS) in older (≥60 years) versus younger (<60 years) patients with treatment-resistant depression (TRD), and to determine whether age affects clinical outcomes in a naturalistic clinical setting.
METHOD: A retrospective analysis was conducted on 272 patients with TRD treated with rTMS at a tertiary psychiatric hospital. Depression severity was assessed at baseline, end-of-treatment (V1), and one-month follow-up (V2) using the Montgomery-Åsberg Depression Rating Scale (MADRS) and the Beck Depression Inventory (BDI). Response (≥50% MADRS reduction) and remission (MADRS ≤10) rates were calculated. Repeated measures ANOVA and logistic regression were used to examine the influence of age and treatment protocol.
RESULTS: Both age groups showed significant improvement in depressive symptoms. Older adults had higher remission rates at V1 (36% vs. 23%, p = 0.033), although this difference was no longer significant at V2. No interaction between age and protocol was observed. Female sex was the only significant predictor of remission at V2 (OR = 14.25, p = 0.021). Sensitivity analyses treating age as a continuous variable yielded consistent findings.
CONCLUSION: rTMS is an effective treatment for TRD in both older and younger adults. Older patients respond comparably to younger ones, challenging concerns about age-related reductions in neuromodulation efficacy. These findings support the use of rTMS in late-life depression without major protocol adjustments and underscore the need for future studies examining personalized treatment parameters and psychosocial moderators of response.
PMID:40279336 | DOI:10.1080/13607863.2025.2490997
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