# ADEPT-ICU: Attenuating Depression with Internet Cognitive Behavioral Therapy (CBT) to Slow Cognitive Decline in Older Intensive Care Unit (ICU) Survivors

> **NIH NIH R01** · INDIANA UNIVERSITY INDIANAPOLIS · 2024 · $795,205

## Abstract

PROJECT SUMMARY/ABSTRACT
Alzheimer’s disease and related dementias (ADRD) affect 47 million people worldwide with an annual global
cost of $818 billion. The risk of developing ADRD is disproportionately borne by older adults with multiple
chronic conditions from underrepresented racial and ethnic groups (URGs). One such high risk group is older
survivors of critical illness who were admitted to the intensive care units (ICUs). Nearly half of ICU survivors
experience subjective cognitive decline (SCD), i.e., perceived decline in memory and thinking even with normal
objective cognitive data. With over 5 million adult ICU admissions in the US each year, an intervention reducing
SCD in older ICU survivors could significantly prevent or lower the incidence of ADRD. Thus, there is an urgent
need for an inclusive randomized controlled trial (RCT) to rigorously test whether a novel, accessible, and
scalable intervention can reduce SCD in a diverse cohort of older ICU survivors. One potential target for such
interventions is depression in ICU survivors. To date, there are no large scale RCTs which have rigorously
tested whether depression focused psychotherapies, such as cognitive behavioral therapy (CBT), reduce SCD
in a diverse cohort of older ICU survivors with depression. To address this knowledge gap, we have created a
multi-PI team based at the Indiana University Center for Aging Research and the Indiana Alzheimer’s Disease
Research Center, with complementary expertise in geriatric psychiatry, ICU survivorship, and psychology. Our
multi-PI team proposes a two-arm RCT called “Attenuating DEPression with Internet CBT to Slow Cognitive
Decline in Older ICU Survivors” (ADEPT-ICU). ADEPT-ICU will test the efficacy of an existing internet CBT
intervention Good Days Ahead (GDA) compared to an active control, for slowing cognitive decline among older
ICU survivors with depression after ICU hospitalization. GDA is an evidence-based, therapist-assisted CBT
that uses a scalable internet-based platform. Leveraging our well-established ICU recruitment infrastructure,
we will enroll a cohort of 300 older ICU survivors with moderate to severe depression (≥10 total score on
Patient Health Questionnaire-9 [PHQ-9]), with ≥50% identifying as Black or Hispanic/Latino or completing ≤12
years of education. Our central hypothesis is that successful treatment of depression with the GDA intervention
will reduce SCD, slow objective cognitive decline, and improve quality of life in a diverse cohort of ICU
survivors with depression. To test this hypothesis, we propose the following aims: Aim 1. Determine the effect
of internet CBT-D on SCD in older ICU survivors with depression. Aim 2. Determine the effect of internet CBT-
D on objective cognitive function in older ICU survivors with depression. Aim 3. Determine the effect of internet
CBT-D on quality of life in older ICU survivors with depression.

## Key facts

- **NIH application ID:** 10999495
- **Project number:** 1R01AG084754-01A1
- **Recipient organization:** INDIANA UNIVERSITY INDIANAPOLIS
- **Principal Investigator:** Babar A Khan
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $795,205
- **Award type:** 1
- **Project period:** 2024-08-15 → 2029-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10999495

## Citation

> US National Institutes of Health, RePORTER application 10999495, ADEPT-ICU: Attenuating Depression with Internet Cognitive Behavioral Therapy (CBT) to Slow Cognitive Decline in Older Intensive Care Unit (ICU) Survivors (1R01AG084754-01A1). Retrieved via AI Analytics 2026-06-13 from https://api.ai-analytics.org/grant/nih/10999495. Licensed CC0.

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