Hostname: page-component-cd4964975-g4d8c Total loading time: 0 Render date: 2023-03-30T01:39:45.995Z Has data issue: true Feature Flags: { "useRatesEcommerce": false } hasContentIssue true

A comparison of neurocognitive impairment in younger and older adults with major depression

Published online by Cambridge University Press:  30 July 2008

A. J. Thomas*
Institute for Ageing and Health, Newcastle University, UK
P. Gallagher
School of Neurology, Neurobiology and Psychiatry, Newcastle University, UK
L. J. Robinson
School of Neurology, Neurobiology and Psychiatry, Newcastle University, UK
R. J. Porter
Department of Psychological Medicine, Christchurch School of Medicine, New Zealand
A. H. Young
School of Neurology, Neurobiology and Psychiatry, Newcastle University, UK
I. N. Ferrier
School of Neurology, Neurobiology and Psychiatry, Newcastle University, UK
J. T. O'Brien
Institute for Ageing and Health, Newcastle University, UK
*Address for correspondence: Dr A. J. Thomas, Wolfson Research Centre, Institute for Ageing and Health, Newcastle General Hospital, Newcastle upon Tyne NE4 6BE, UK. (Email:



Neurocognitive impairment is a well-recognized feature of depression that has been reported in younger and older adults. Similar deficits occur with ageing and it is unclear whether the greater deficits in late-life depression are an ageing-related phenomenon or due to a difference in the nature of late-life depression itself. We hypothesized that ageing alone would not fully explain the increased neurocognitive impairment in late-life depression but that differences in the illness explain the greater decrements in memory and executive function.


Comparison of the neuropsychological performance of younger (<60 years) and older (⩾60 years) adults with major depressive disorder (MDD) and healthy comparison subjects. Scores for each depression group were normalized against their respective age-matched control group and the primary comparisons were on four neurocognitive domains: (i) attention and executive function; (ii) verbal learning and memory; (iii) visuospatial learning and memory; and (iv) motor speed.


We recruited 75 subjects with MDD [<60 years (n=44), ⩾60 years (n=31)] and 82 psychiatrically healthy comparison subjects [<60 years (n=42), ⩾60 years (n=40)]. The late-life depression group had greater impairment in verbal learning and memory and motor speed but not in executive function. The two depressed groups did not differ in depression severity, global cognitive function, intelligence or education.


Late-life depression is associated with more severe impairment in verbal learning and memory and motor speed than depression in earlier adult life and this is not due to ageing alone.

Original Articles
Copyright © Cambridge University Press 2008

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)


Abas, MA, Sahakian, BJ, Levy, R (1990). Neuropsychological deficits and CT scan changes in elderly depressives. Psychological Medicine 20, 507520.CrossRefGoogle ScholarPubMed
Austin, MP, Mitchell, P, Goodwin, GM (2001). Cognitive deficits in depression: possible implications for functional neuropathology. British Journal of Psychiatry 178, 200206.CrossRefGoogle ScholarPubMed
Austin, MP, Mitchell, P, Wilhelm, K, Parker, G, Hickie, I, Brodaty, H, Chan, J, Eyers, K, Milic, M, Hadzi-Pavlovic, D (1999). Cognitive function in depression: a distinct pattern of frontal impairment in melancholia? Psychological Medicine 29, 7385.CrossRefGoogle ScholarPubMed
Beats, BC, Sahakian, BJ, Levy, R (1996). Cognitive performance in tests sensitive to frontal lobe dysfunction in the elderly depressed. Psychological Medicine 26, 591603.CrossRefGoogle ScholarPubMed
Benton, AL, Hampsher, K (1976). Multilingual Aphasia Examination. University of Iowa: Iowa City.Google Scholar
Bhalla, RK, Butters, MA, Mulsant, BH, Begley, AE, Zmuda, MD, Schoderbek, B, Pollock, BG, Reynolds, CF 3rd, Becker, JT (2006). Persistence of neuropsychologic deficits in the remitted state of late-life depression. American Journal of Geriatric Psychiatry 14, 419427.CrossRefGoogle ScholarPubMed
Brodaty, H, Luscombe, G, Parker, G, Wilhelm, K, Hickie, I, Austin, MP, Mitchell, P (1997). Increased rate of psychosis and psychomotor change in depression with age. Psychological Medicine 27, 12051213.CrossRefGoogle ScholarPubMed
Brodaty, H, Peters, K, Boyce, P, Hickie, I, Parker, G, Mitchell, P, Wilhelm, K (1991). Age and depression. Journal of Affective Disorders 23, 137149.CrossRefGoogle ScholarPubMed
Butters, MA, Becker, JT, Nebes, RD, Zmuda, MD, Mulsant, BH, Pollock, BG, Reynolds, CF 3rd (2000). Changes in cognitive functioning following treatment of late-life depression. American Journal of Psychiatry 157, 19491954.CrossRefGoogle ScholarPubMed
Butters, MA, Bhalla, RK, Mulsant, BH, Mazumdar, S, Houck, PR, Begley, AE, Dew, MA, Pollock, BG, Nebes, RD, Becker, JT, Reynolds, CF 3rd (2004 a). Executive functioning, illness course, and relapse/recurrence in continuation and maintenance treatment of late-life depression: is there a relationship? American Journal of Geriatric Psychiatry 12, 387394.Google ScholarPubMed
Butters, MA, Whyte, EM, Nebes, RD, Begley, AE, Dew, MA, Mulsant, BH, Zmuda, MD, Bhalla, R, Meltzer, CC, Pollock, BG, Reynolds, CF 3rd, Becker, JT (2004 b). The nature and determinants of neuropsychological functioning in late-life depression. Archives of General Psychiatry 61, 587595.CrossRefGoogle ScholarPubMed
Cegalis, J, Bowen, J (1991). Vigil: Software for the Assessment of Attention. Forthought: Nashua, NA.Google Scholar
de Frias, CM, Nilsson, L-G, Herlitz, A (2006). Sex differences in cognition are stable over a 10-year period in adulthood and old age. Aging, Neuropsychology, and Cognition 13, 574587.CrossRefGoogle Scholar
Elliott, R, Baker, SC, Rogers, RD, O'Leary, DA, Paykel, ES, Frith, CD, Dolan, RJ, Sahakian, BJ (1997). Prefrontal dysfunction in depressed patients performing a complex planning task: a study using positron emission tomography. Psychological Medicine 27, 931942.CrossRefGoogle ScholarPubMed
Folstein, MF, Folstein, SE, McHugh, PR (1975). ‘Mini-mental state’. A practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research 12, 189198.CrossRefGoogle Scholar
Furlan, PM, Kallan, MJ, Ten Have, T, Pollock, BG, Katz, I, Lucki, I (2001). Cognitive and psychomotor effects of paroxetine and sertraline on healthy elderly volunteers. American Journal of Geriatric Psychiatry 9, 429438.CrossRefGoogle ScholarPubMed
Gallagher, P, Robinson, LJ, Gray, JM, Porter, RJ, Young, AH (2007). Neurocognitive function following remission in major depressive disorder: potential objective marker of response? Australian and New Zealand Journal of Psychiatry 41, 5461.CrossRefGoogle ScholarPubMed
Hasbroucq, T, Rihet, P, Blin, O, Possamai, CA (1997). Serotonin and human information processing: fluvoxamine can improve reaction time performance. Neuroscience Letters 229, 204208.CrossRefGoogle ScholarPubMed
Herlitz, A, Airaksinen, E, Nordstrom, E (1999). Sex differences in episodic memory: the impact of verbal and visuospatial ability. Neuropsychology 13, 590597.CrossRefGoogle ScholarPubMed
Herlitz, A, Nilsson, LG, Backman, L (1997). Gender differences in episodic memory. Memory and Cognition 25, 801811.CrossRefGoogle ScholarPubMed
Herrmann, LL, Goodwin, GM, Ebmeier, KP (2007). The cognitive neuropsychology of depression in the elderly. Psychological Medicine 37, 16931702.CrossRefGoogle ScholarPubMed
Hornblow, AR, Bushnell, JA, Wells, JE, Joyce, PR, Oakley-Browne, MA (1990). Christchurch Psychiatric Epidemiology Study: use of mental health services. New Zealand Medical Journal 103, 415417.Google ScholarPubMed
Jokinen, H, Kalska, H, Mantyla, R, Pohjasvaara, T, Ylikoski, R, Hietanen, M, Salonen, O, Kaste, M, Erkinjuntti, T (2006). Cognitive profile of subcortical ischaemic vascular disease. Journal of Neurology, Neurosurgery and Psychiatry 77, 2833.CrossRefGoogle ScholarPubMed
Kalayam, B, Alexopoulos, GS (1999). Prefrontal dysfunction and treatment response in geriatric depression. Archives of General Psychiatry 56, 713718.CrossRefGoogle ScholarPubMed
Kramer-Ginsberg, E, Greenwald, BS, Krishnan, KR, Christiansen, B, Hu, J, Ashtari, M, Patel, M, Pollack, S (1999). Neuropsychological functioning and MRI signal hyperintensities in geriatric depression. American Journal of Psychiatry 156, 438444.Google ScholarPubMed
Lesser, IM, Boone, KB, Mehringer, CM, Wohl, MA, Miller, BL, Berman, NG (1996). Cognition and white matter hyperintensities in older depressed patients. American Journal of Psychiatry 153, 12801287.Google ScholarPubMed
Lewin, C, Wolgers, G, Herlitz, A (2001). Sex differences favoring women in verbal but not in visuospatial episodic memory. Neuropsychology 15, 165173.CrossRefGoogle ScholarPubMed
Lockwood, KA, Alexopoulos, GS, van Gorp, WG (2002). Executive dysfunction in geriatric depression. American Journal of Psychiatry 159, 11191126.CrossRefGoogle ScholarPubMed
Montgomery, SA, Åsberg, M (1979). A new depression scale designed to be sensitive to change. British Journal of Psychiatry 134, 382389.CrossRefGoogle ScholarPubMed
Mowla, A, Mosavinasab, M, Pani, A (2007). Does fluoxetine have any effect on the cognition of patients with mild cognitive impairment? A double-blind, placebo-controlled, clinical trial. Journal of Clinical Psychopharmacology 27, 6770.CrossRefGoogle ScholarPubMed
Nelson, HE (1982). National Adult Reading Test, NART. Nelson Publishing Company: Windsor.Google Scholar
Nyenhuis, DL, Gorelick, PB, Geenen, EJ, Smith, CA, Gencheva, E, Freels, S, deToledo-Morrell, L (2004). The pattern of neuropsychological deficits in Vascular Cognitive Impairment-No Dementia (Vascular CIND). Clinical Neuropsychologist 18, 4149.CrossRefGoogle Scholar
O'Brien, JT (2006). Vascular cognitive impairment. American Journal of Geriatric Psychiatry 14, 724733.CrossRefGoogle ScholarPubMed
O'Brien, JT, Ames, D, Schweitzer, I, Colman, P, Desmond, P, Tress, B (1996). Clinical and magnetic resonance imaging correlates of hypothalamic-pituitary-adrenal axis function in depression and Alzheimer's disease. British Journal of Psychiatry 168, 679687.CrossRefGoogle ScholarPubMed
O'Brien, JT, Lloyd, A, McKeith, I, Gholkar, A, Ferrier, N (2004). A longitudinal study of hippocampal volume, cortisol levels, and cognition in older depressed subjects. American Journal of Psychiatry 161, 20812090.CrossRefGoogle ScholarPubMed
O'Brien, JT, Sahakian, BJ, Checkley, SA (1993). Cognitive impairments in patients with seasonal affective disorder. British Journal of Psychiatry 163, 338343.CrossRefGoogle ScholarPubMed
Paradiso, S, Lamberty, GJ, Garvey, MJ, Robinson, RG (1997). Cognitive impairment in the euthymic phase of chronic unipolar depression. Journal of Nervous and Mental Disease 185, 748754.CrossRefGoogle ScholarPubMed
Porter, RJ, Bourke, C, Gallagher, P (2007). Neuropsychological impairment in major depression: its nature, origin and clinical significance. Australia and New Zealand Journal of Psychiatry 41, 115128.CrossRefGoogle ScholarPubMed
Porter, RJ, Gallagher, P, Thompson, JM, Young, AH (2003). Neurocognitive impairment in drug-free patients with major depressive disorder. British Journal of Psychiatry 182, 214220.CrossRefGoogle ScholarPubMed
Rey, A (1964). Clinical Examination in Psychology. University of Paris: ParisGoogle Scholar
Rubin, RT, Poland, RE, Lesser, IM, Martin, DJ, Blodgett, AL, Winston, RA (1987). Neuroendocrine aspects of primary endogenous depression. III. Cortisol secretion in relation to diagnosis and symptom patterns. Psychological Medicine 17, 609619.CrossRefGoogle ScholarPubMed
Salloway, S, Malloy, P, Kohn, R, Gillard, E, Duffy, J, Rogg, J, Richardson, E, Thomas, C, Westlake, R (1996). MRI and neuropsychological differences in early- and late-life-onset geriatric depression. Neurology 46, 15671574.CrossRefGoogle ScholarPubMed
Sheline, YI, Barch, DM, Garcia, K, Gersing, K, Pieper, C, Welsh-Bohmer, K, Steffens, DC, Doraiswamy, PM (2006). Cognitive function in late life depression: relationships to depression severity, cerebrovascular risk factors and processing speed. Biological Psychiatry 60, 5865.CrossRefGoogle ScholarPubMed
Siepmann, M, Grossmann, J, Muck-Weymann, M, Kirch, W (2003). Effects of sertraline on autonomic and cognitive functions in healthy volunteers. Psychopharmacology 168, 293298.CrossRefGoogle ScholarPubMed
Simpson, S, Baldwin, RC, Jackson, A, Burns, AS (1998). Is subcortical disease associated with a poor response to antidepressants? Neurological, neuropsychological and neuroradiological findings in late life depression. Psychological Medicine 28, 10151026.CrossRefGoogle ScholarPubMed
Steffens, DC, Byrum, CE, McQuoid, DR, Greenberg, DL, Payne, ME, Blitchington, TF, MacFall, JR, Krishnan, KR (2000). Hippocampal volume in geriatric depression. Biological Psychiatry 48, 301309.CrossRefGoogle ScholarPubMed
Tarbuck, AF, Paykel, ES (1995). Effects of major depression on the cognitive function of younger and older subjects. Psychological Medicine 25, 285295.CrossRefGoogle ScholarPubMed