Anxiety DisordersOlder AdultsDepressive DisordersNeurocognitive DisordersSet & SettingInterpersonal Functioning & Social Connectedness

Effects of psychedelics in older adults: A prospective cohort study

This prospective cohort study (n=124, 62 older adults) investigates the effects of a guided psychedelic group session on well-being in older adults (OA) compared to younger adults (YA). Mixed linear regression analyses show significant improvements in well-being in both groups, particularly amplified in OA with a history of psychiatric diagnosis. Acute subjective psychedelic effects were attenuated in OA compared to YA, but a psychosocial measure of Communitas emerged as a predictor in OA, indicating the potential value of relational components in psychedelic group settings for OA.

Authors

  • Robin Carhart-Harris
  • Leor Roseman
  • Hannes Kettner

Published

The American Journal of Geriatric Psychiatry
individual Study

Abstract

Objective
Affective symptoms such as anxiety, low mood, and loneliness are prevalent and highly debilitating symptoms among older adults (OA). Serotonergic psychedelics are currently investigated as novel interventions for affective disorders, yet little is known regarding their effects in OA. We investigated the mental health effects and psychological mechanisms of guided psychedelic group experiences in OA and a matched sample of younger adults (YA).

Methods
Using a prospective observational cohort design, we identified 62 OA (age ≥60 years) and 62 matched YA who completed surveys two weeks before, a day, two weeks, four weeks, and six months after a psychedelic group session. Mixed linear regression analyses were used to investigate longitudinal well-being changes, as well as baseline, acute, and post-acute predictors of change.


Results
OA showed post-psychedelic well-being improvements similar to matched YA. Among baseline predictors, presence of a lifetime psychiatric diagnosis was associated with greater well-being increases in OA (B = 6.72, p = .016 at the four-week key-endpoint). Compared to YA, acute subjective psychedelic effects were less intense in OA and did not significantly predict prospective well-being changes. However, relational experiences before and after psychedelic sessions emerged as predictors in OA (r(36) = .37,p = 0.025).

Conclusions
Guided psychedelic group sessions enhance well-being in OA in line with prior naturalistic and controlled studies in YA. Interestingly, acute psychedelic effects in OA are attenuated and less predictive of well-being improvements, with relational experiences related to the group setting playing a more prominent role. Our present findings call for further research on the effects of psychedelics in OA.

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Research Summary of 'Effects of psychedelics in older adults: A prospective cohort study'

Introduction

Emotional functioning and social connectedness change across the adult life span, with older adults (OA) often prioritising emotional regulation and reporting more positive affect than younger people. Nevertheless, affective symptoms—such as anxiety, low mood, loneliness and apathy—remain common and have important consequences for cognition and mental health in later life, including increased risk for late-life depression and dementia. Conventional antidepressants have shown reduced efficacy and higher rates of some adverse effects in older populations, motivating interest in alternative treatments. Serotonergic psychedelics (for example psilocybin, LSD, DMT/ayahuasca and mescaline) have emerged in recent clinical research as candidate interventions for affective disorders; their acute subjective effects (e.g. ego-dissolution, mystical-type experiences, emotional breakthrough) have often been proposed as mediators of therapeutic benefit. However, older adults are markedly underrepresented in psychedelic trials, leaving safety, efficacy and mechanisms of action in this age group largely unknown. L. and colleagues set out to examine whether guided psychedelic group sessions are associated with changes in mental well-being among older adults, and whether the psychological mechanisms that predict any changes differ from those observed in younger adults (YA). Using a prospective observational cohort design in people attending naturalistic guided group psychedelic ceremonies or retreats, the study aimed to (1) measure longitudinal changes in well-being up to six months post-session in OA, (2) compare those changes with a matched sample of younger adults, and (3) investigate baseline, acute and post-acute predictors of well-being change, with particular attention to relational experiences in group settings.

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Study Details

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