A model for modifying interpersonal psychotherapy (IPT) for depressed elders with cognitive impairment

The authors review the psychological and emotional aspects of late-life depression complicated by cognitive impairment and propose a treatment model for modifying interpersonal psychotherapy (IPT) to better serve this group of patients and their family caregivers. The key component of this modification, named "IPT-CI" (for Cognitive Impairment) is a combined patient/caregiver approach that provides psychoeducation for both parties, opportunity for problem solving for both parties individually, and a forum for role dispute resolution through joint meetings. Caregivers thus have regular input into the therapeutic process and are encouraged to extend the therapeutic work between meetings to help the patient to maintain progress despite memory loss and/or impairments in insight, judgment, or executive function. A detailed case vignette provides an illustration of the use of this modified form of IPT.