Those seeking an effective treatment for depression may wonder if TMS is right for them. A common question before beginning treatment is, “Are response rates of TMS related to age?” The answer is: age is not a considerable factor in the response rate of TMS therapy.
According to a 2018 CDC report, during 2013–2016, 8.1% of Americans aged 20 and over had depression in a given 2-week period. Furthermore, the CDC notes, rates of depression did not differ statistically across age groups. Depression is equally as prevalent in younger adults as it is among senior citizens.
In all stages of life, those struggling with depression experience symptoms such as pervasive sadness, fatigue, insomnia, poor concentration, inability to enjoy activities, appetite changes, irritability, and restlessness. The biological and physiological causes of depression also remain steadfast across age demographics.
The good news is that depression is treatable—including with TMS–at any age. A 2016 article that examined data from eleven different studies demonstrated that over 46 percent of people respond to TMS and concluded that clinical and demographic variables do not “exert a sufficiently strong influence on response rates to warrant using these criteria to exclude patients from treatment.”
Depression in the Elderly
Major depression is, to a great extent, the consequence of dysregulation in the brain, specifically in the outer layer of the cerebrum. Located at the front of the skull, the cerebrum is split into two different hemispheres–the right and left. Depression is associated with reduced activity in the patient’s left dorsolateral prefrontal cortex (DLPFC) and often increased activity in the right DLPFC. High-frequency unilateral TMS treatment enhances the reduced activity in the left DLPFC. Bilateral TMS will increase excitability in the left DLPFC while reducing activity in the right DLPC, making both sides more equal. Mid City TMS offers both Bilateral and Unilateral TMS treatment
Older adults are at an increased risk for depression. About 80% of older adults have at least 1 chronic health condition and 50% have 2 or more. Often, older people’s depression is overlooked and not diagnosed due to doctors believing that the changes in behavior are just because of the circumstances of the patient’s life. You may be at a greater risk of depression if you have any of the following things:
- have a chronic medical illness, such as cancer, diabetes or heart disease
- have a disability
- sleep poorly
- are lonely or socially isolated
- have a personal or family history of depression
- use certain medications
- suffer from a brain disease
- misuse alcohol or drugs
- have experienced stressful life events such as the loss of a spouse, divorce, or taking care of someone with a chronic illness
However, if you have any of the listed ailments, there are many treatment options available to you. There is the traditional route of antidepressants, but as you get older the chances of missing a dose, or having an adverse reaction to medication increase. Typically, antidepressants take 6-8 weeks to become effective; however, for older people, there might need to be a lot of adjustments to your dose which can delay any therapeutic response and be difficult on your body.
Age and TMS Response
Clinical trials have demonstrated that age does not have a significant bearing on the efficacy of TMS therapy. A 2013 study conducted in a clinical setting over the course of three months found that TMS is effective “independent of patient age.”
This study’s participants were evaluated using the Hamilton Depression Rating Scale and the Beck Depression Inventory at baseline, after three weeks of treatment, and then one and three months following the final TMS session. The study divided its cohort into two groups: one over sixty-five years old and one under sixty-five years old. The antidepressant effect of TMS therapy observed in both groups did not differ at the conclusion of treatment or at the follow-up evaluations. A comparable number of responders to TMS treatment were found in both groups; the study found “no evidence of age affecting the outcome at three months after the last session.” Additionally, the treatment was observed to have “a significant effect over time.”
TMS For Treatment-Resistant Depression Across Age
Another recent study found that the effectiveness of TMS for alleviating treatment-resistant depression is not differentially modified by age. Participants were broken up into two groups: one group consisted of individuals over the age of 60 and the other consisted of individuals under the age of 60. Both groups completed an acute course of outpatient TMS therapy at two outpatient clinics and performed self-report depression scales before and after treatment.
The study compared changes in continuous measures and categorical outcomes for older and younger participants. Data demonstrated that both age groups exhibited significant improvements in depression symptoms. There was not a discrepancy in response and remission rates between age groups. Overall, the study concluded that “age group was not a significant predictor of change in depression severity, nor of clinical response or remission, in a model controlling for other predictors.”
Responses In Elderly Patients
Another 2013 study measured the safety and effectiveness of TMS in elderly depressed patients. The study treated sixty-five depressed seniors with TMS therapy six days per week over the course of three weeks. Depression was measured using the Hamilton Depression Rating Scale prior to and following treatment. The study defined response to TMS as a fifty percent decrease in a patient’s Hamilton Depression Rating score and patients with scores of less than eight were defined as being in remission.
The group’s average Hamilton Depression Rating score shrank from 21.94 ± 5.12 prior to TMS therapy to 11.28 ± 4.56 after the course of therapy ended. After treatment, nearly sixty percent of participants showed a serious improvement in mood, as evidenced by a decrease of nearly fifty percent in their Hamilton Depression Rating scores.
Almost a third of patients in the study achieved remission, while over forty percent attained a partial response. No participants demonstrated an increased Hamilton Depression Rating score at the end of the study and no serious adverse effects were observed. In short, this study added to a growing body of support for TMS as a safe and effective antidepressant treatment for adults over the age of sixty.
A study, published in 2022, used a large sample size of 495 patients from ages 15 to 78 with moderate or severe Major Depressive Disorder. These patients had 5 TMS sessions a week until they received 30 sessions and following that, they had 6-8 taper sessions, which is a common protocol and the one we use most often at Mid City TMS. Also similar to what we typically recommend to our patients at Mid City TMS, while undergoing toe course of TMS, patients were discouraged from changing their medication and those who were in therapy continued to see their therapists. After the study concluded, it was found that the TMS treatment was equally effective across all age groups.
Mid City TMS Can Help At Any Age
By 2030, around 20% of the population will be made up of adults over the age of 65. Geriatric depression and many adverse reactions to pharmaceuticals in the elderly create a high need for non-medication treatments for depression. If you are suffering from depression, Mid City TMS is here to help. TMS is a safe and proven treatment for depression that is effective for patients of all ages. TMS has been FDA approved since 2008. TMS is also covered by Medicare. At Mid City TMS, we will work with you and your other healthcare providers to make sure you get the treatment you need. Contact us today to see if TMS therapy is right for you.