ECT and the Elderly

As already noted, elderly women have become the most frequent target of ECT. The elderly, of course, have more fragile brains and are especially sensitive to biopsychiatric interventions, even relatively mild doses of drugs. In addition, many elderly already suffer from memory dysfunction 

Against all common sense, the APA (1990b) task force advised that ECT can be used regardless of age (p. 15) and cited the successful treatment of a patient aged 102 (pp. 71-72). It did warn, however, that some elderly patients may have an increased likelihood of appreciable memory deficits and confusion during the course of treatment (p. 72). 

In a study involving 3 times as many women as men, Kroessler and Fogel (1993) produced data indicating that ECT can cause a devastating decline in longevity  

This is a longitudinal study of 65 patients who were 80 years old or older at the time they were hospitalized for depression. Thirty-seven were treated with ECT and 28 with medication. Survival after 1, 2, and 3 years in the ECT group was 73.0%, 54.1%, and 51.4% respectively. Survival after 1, 2, and 3 years in the non-ECT group was 96.4%, 90.5%, and 75.0% respectively, (p. 30) 

These are extraordinary findings, indicating a very high increase in mortality in the elderly who received ECT. The authors, however, argued that the patients receiving ECT were more physically ill and hence at greater risk of dying. They provided no data to justify this speculation or to otherwise explain such a vast difference in mortality. 

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