Treating complicated grief in the elderly

As we age we are likely to lose loved ones.

There are now about 40 million Americans over age 65. About 40% of women and 13% of men over 65 are widowed. Many are also mourning other close family and friends. Older people are as likely as younger ones to develop complicated grief. Their higher rates of loss mean that more older than younger people are likely to have this condition.

Our bodies and minds change as we age so we cannot assume treatments that are effective for younger adults will necessarily help older people.

For example CGT uses procedures that are highly emotionally activating and therapists have wondered whether they should use these in older adults. CGT focuses on aspirational goals and people sometimes wonder if an elderly person can still have goals. These are just a few examples of ways older and younger adults might need to be treated differently. To determine whether older adults would respond similarly to younger ones, we conducted a clinical trial of CGT focused on older adults funded by the National Institute of Mental Health. The average age of study participants was 66 years.

Study results revealed that more than twice as many participants responded to CGT, compared to standard Interpersonal Psychotherapy (IPT), an efficacious treatment for depression.

These results were similar to those of our previous study of younger adults. Participants’ ages ranged from 50 to 91 but age did not have an effect on these results.

Importantly older adults responded to the emotion activating procedures similarly to younger people and none discontinued CGT due to side effects.

71% of participants receiving CGT were much or very much improved by the end of the treatment, compared to only 32% of those who received IPT. Response was maintained for at least 6 months after treatment ended.

Study data showed that CGT was more beneficial than IPT in several other ways including:

  • More improvement in symptoms of depression
  • Less grief-related work impairment
  • Better social adjustment
  • Less grief-related avoidance
Results demonstrating CGT efficacy in older adults were published in 2014.