NCT06627894

Brief Summary

Depression affects one-third of intensive care unit (ICU) survivors and represents a potentially modifiable target to slow cognitive decline and reduce the risk of Alzheimer's disease and related dementias (ADRD). Our multi-PI team proposes a two-arm RCT called ADEPT-ICU (Attenuating DEPression with Internet CBT to Slow Cognitive Decline in Older ICU Survivors), which will test the efficacy of an internet CBT intervention called Good Days Ahead (GDA) to reduce the burden of subjective cognitive decline (SCD) in older ICU survivors with moderate to severe depressive symptoms after ICU hospitalization.

Trial Health

77
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
300

participants targeted

Target at P75+ for not_applicable depression

Timeline
42mo left

Started Mar 2025

Longer than P75 for not_applicable depression

Geographic Reach
1 country

2 active sites

Status
recruiting

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

Study Progress25%
Mar 2025Oct 2029

First Submitted

Initial submission to the registry

October 3, 2024

Completed
1 day until next milestone

First Posted

Study publicly available on registry

October 4, 2024

Completed
5 months until next milestone

Study Start

First participant enrolled

March 13, 2025

Completed
4.6 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

October 30, 2029

Expected
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

October 30, 2029

Last Updated

December 17, 2025

Status Verified

October 1, 2025

Enrollment Period

4.6 years

First QC Date

October 3, 2024

Last Update Submit

December 13, 2025

Conditions

Keywords

DepressionCognition

Outcome Measures

Primary Outcomes (1)

  • Subjective Cognitive Decline

    The primary outcome will be subjective cognitive decline (SCD), measured using the Cognitive Change Index self-report version (CCI-SR).

    Measured at 6-month and 12-month follow-up.

Secondary Outcomes (2)

  • Cognition status

    Measured at 6-month and 12-month follow-up.

  • Quality of Life physical and mental component status

    Measured at 6-month and 12-month follow-up.

Study Arms (2)

Intervention - Internet Cognitive-Behavioral Therapy (CBT) for Depression

EXPERIMENTAL

Participants will complete nine 45-minute sessions of an internet CBT for depression called Good Days Ahead (GDA; MindStreet, Inc.) with 20 minutes of therapist assistance per session on the phone over six months.

Behavioral: Therapist-Assisted Internet Cognitive-Behavioral Therapy for Depression

Active Control - Depression Education, Symptom Monitoring, and Usual Care

ACTIVE COMPARATOR

Participants will review nine 45-minute segments of depression education material on their own with 20 minutes of therapist assistance per segment on the phone over six months. They will also have access to and could receive current depression care in the targeted healthcare systems.

Behavioral: Active Control

Interventions

Active ControlBEHAVIORAL

Depression education, symptom monitoring, and standard depression care

Active Control - Depression Education, Symptom Monitoring, and Usual Care

Good Days Ahead (MindStreet, Inc.)

Intervention - Internet Cognitive-Behavioral Therapy (CBT) for Depression

Eligibility Criteria

Age50 Years+
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • years of age and older
  • Admitted to the intensive care for greater \> 48 hours
  • Able to understand and provide informed consent
  • Elevated depressive symptoms, defined as Screening PHQ-9 or PHQ-8 ≥ 10 or Screening PHQ-9 or PHQ-8 = 5-9 with the presence a core symptom of anhedonia (PHQ-9 or PHQ-8 Item 1) or depressed mood (PHQ-9 or PHQ-8 Item 2)
  • Willing to participate in cognitive testing
  • Access to a telephone
  • Discharge to home or an independent or assisted living facility
  • Response is a 1,2, or 3 on PHQ-9 or PHQ-8 item 7, answered yes to "Have you experienced a change in your memory or other aspect of thinking in the past 1 to 3 years?", or score in the 25% percentile or lower on the Montreal Cognitive Assessment (MOCA) based on normative data which account for age, gender, race, ethnicity and education.

You may not qualify if:

  • Diagnosis of dementia or neurodegenerative disease (e.g. Alzheimer's disease, vascular dementia as per EHR and IQCODE, or Parkinson's disease) or on anti-dementia medications prior to ICU stay
  • Diagnosis of severe mental illness (bipolar disorder, schizophrenia, schizoaffective) as per EHR and screening questions
  • Persistent psychotic symptoms after ICU stay which would interfere with successful completion of intervention
  • Recent or recurrent alcohol or substance use disorder as per HER and Drug Abuse Screening Test
  • Life expectancy less than 1 year (e.g. terminal cancer diagnosis, discharged on hospice)
  • Ischemic or hemorrhagic stroke, traumatic brain injury, or undergoing neurosurgery prior, during or after ICU stay
  • Uncorrected visual or auditory impairment including legal blindness or deaf
  • Status post tracheostomy and not able to communicate
  • Incarcerated or on parole after ICU stay

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (2)

Eskenazi Hospital

Indianapolis, Indiana, 46202, United States

RECRUITING

IU Health Methodist Hospital

Indianapolis, Indiana, 46202, United States

RECRUITING

MeSH Terms

Conditions

DepressionCognitive Dysfunction

Condition Hierarchy (Ancestors)

Behavioral SymptomsBehaviorCognition DisordersNeurocognitive DisordersMental Disorders

Study Officials

  • Babar Khan, MD, MS

    Indiana University

    PRINCIPAL INVESTIGATOR

Central Study Contacts

Babar Khan, MD, MS

CONTACT

Lori Rawlings, RN, BSN

CONTACT

Study Design

Study Type
interventional
Phase
not applicable
Allocation
RANDOMIZED
Masking
DOUBLE
Who Masked
INVESTIGATOR, OUTCOMES ASSESSOR
Masking Details
The unblinded study coordinator is aware of randomization. The investigator and study team members responsible for the delivery of the intervention will be unblinded. The study team staff performing outcomes assessments and the investigators overseeing this process will be blinded.
Purpose
TREATMENT
Intervention Model
PARALLEL
Model Details: Internet based CBT-D vs Active Control
Sponsor Type
OTHER
Responsible Party
PRINCIPAL INVESTIGATOR
PI Title
Professor of Medicine

Study Record Dates

First Submitted

October 3, 2024

First Posted

October 4, 2024

Study Start

March 13, 2025

Primary Completion (Estimated)

October 30, 2029

Study Completion (Estimated)

October 30, 2029

Last Updated

December 17, 2025

Record last verified: 2025-10

Locations