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The pattern and course of cognitive impairment in late-life depression

  • S. Köhler (a1) (a2), A. J. Thomas (a1), N. A. Barnett (a1) and J. T. O'Brien (a1)
  • DOI: http://dx.doi.org/10.1017/S0033291709990833
  • Published online: 06 August 2009
Abstract
Background

Cognitive deficits persist despite clinical recovery in subjects with late-life depression, but more needs to be known about their longer-term outcome and factors affecting their course. To investigate this, we followed the pattern of cognitive impairments over time and examined the effects of current mood, remission status, age of depression onset and antidepressant (AD) treatment on these deficits.

Method

Sixty-seven subjects aged ⩾60 years with DSM-IV major depressive disorder and 36 healthy comparison subjects underwent tests of global cognition, memory, executive functioning and processing speed at baseline, 6 and 18 months, with some subjects tested again after 4 years. z scores were compared between groups, with analyses of clinical factors that may have influenced cognitive performance in depressed subjects.

Results

Half of the patients exhibited a generalized cognitive impairment (GCI) that persisted after 18 months. Patients performed worse across all cognitive domains at all time points, without substantial variability due to current mood, remission status or AD treatment. Late age of onset was associated significantly with decline in memory and executive functioning. Impaired processing speed may be a partial mediator of some deficits, but was insufficient to explain differences between patients and controls. Four-year follow-up data suggest impairments persist, but do not further decline.

Conclusions

Cognitive deficits in late-life depression persist up to 4 years, affect multiple domains and are related to trait rather than state effects. Differences in severity and course between early and late onset depression suggest different pathogenic processes.

Copyright
Corresponding author
*Address for correspondence: Professor J. T. O'Brien, Professor of Old Age Psychiatry, Wolfson Research Centre, Institute for Ageing and Health, Newcastle University, Campus for Ageing and Vitality, Newcastle upon TyneNE4 5PL, UK. (Email: j.t.o'brien@ncl.ac.uk)
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This list contains references from the content that can be linked to their source. For a full set of references and notes please see the PDF or HTML where available.

G Adler , K Chwalek , A Jajcevic (2004). Six-month course of mild cognitive impairment and affective symptoms in late-life depression. European Psychiatry 19, 502505.

E Airaksinen , Å Wahlin , M Larsson , Y Forsell (2006). Cognitive and social functioning in recovery from depression: results from a population-based three-year follow-up. Journal of Affective Disorders 96, 107110.

GS Alexopoulos (2006). The vascular depression hypothesis: 10 years later. Biological Psychiatry 60, 13041305.

GS Alexopoulos , BS Meyers , RC Young , S Campbell , D Silbersweig , M Charlson (1997). ‘Vascular depression’ hypothesis. Archives of General Psychiatry 54, 915922.

MP Amato , V Zipoli , E Portaccio (2008). Cognitive changes in multiple sclerosis. Expert Review of Neurotherapeutics 8, 15851596.

RK Bhalla , MA Butters , BH Mulsant , AE Begley , MD Zmuda , B Schoderbek , BG Pollock , CF Reynolds III, JT Becker (2006). Persistence of neuropsychologic deficits in the remitted state of late-life depression. American Journal of Geriatric Psychiatry 14, 419427.

A Bulbena , G Berrios (1986). Pseudodementia: facts and figures. British Journal of Psychiatry 148, 8794.

MA Butters , JT Becker , RD Nebes , MD Zmuda , BH Mulsant , BG Pollock , CF Reynolds III (2000). Changes in cognitive functioning following treatment of late-life depression. American Journal of Psychiatry 157, 19491954.

MA Butters , EM Whyte , RD Nebes , AE Begley , MA Dew , BH Mulsant , MD Zmuda , R Bhalla , CC Meltzer , BG Pollock , CF Reynolds III, JT Becker (2004). The nature and determinants of neuropsychological functioning in late-life depression. Archives of General Psychiatry 61, 587595.

DP Devanand , GH Pelton , K Marston , Y Camacho , SP Roose , Y Stern , HA Sackeim (2003). Sertraline treatment of elderly patients with depression and cognitive impairment. International Journal of Geriatric Psychiatry 18, 123130.

R Gallassi , R Di Sarro , A Morreale , M Amore (2006). Memory impairment in patients with late-onset major depression: the effect of antidepressant therapy. Journal of Affective Disorders 91, 243250.

CT Gualtieri , LG Johnson (2008). Age-related cognitive decline in patients with mood disorders. Progress in Neuro-Psychopharmacology and Biological Psychiatry 32, 962967.

CJ Hawley , TM Gale , T Sivakumaran (2002). Defining remission by cut off score on the MADRS: selecting the optimal value. Journal of Affective Disorders 72, 177184.

LL Herrmann , M Le Masurier , KP Ebmeier (2008). White matter hyperintensities in late life depression: a systematic review. Journal of Neurology, Neurosurgery and Psychiatry 79, 619624.

I Hickie , S Naismith , PB Ward , K Turner , E Scott , P Mitchell , K Wilhelm , G Parker (2005). Reduced hippocampal volumes and memory loss in patients with early- and late-onset depression. British Journal of Psychiatry 186, 197202.

H Lavretsky , K Kurbanyan , M Ballmaier , J Mintz , A Toga , A Kumar (2004). Sex differences in brain structure in geriatric depression. American Journal of Geriatric Psychiatry 12, 653657.

AJ Lloyd , IN Ferrier , R Barber , A Gholkar , AH Young , JT O'Brien (2004). Hippocampal volume change in depression: late- and early-onset illness compared. British Journal of Psychiatry 184, 488495.

L Mandelli , A Serretti , C Colombo , M Florita , A Santoro , D Rossini , R Zanardi , E Smeraldi (2006). Improvement of cognitive functioning in mood disorder patients with depressive symptomatic recovery during treatment: an exploratory analysis. Psychiatry and Clinical Neurosciences 60, 598604.

BS McEwen (2005). Glucocorticoids, depression, and mood disorders: structural remodeling in the brain. Metabolism 54, 2023.

S Montgomery , M Åsberg (1979). A new depression scale designed to be sensitive to change. British Journal of Psychiatry 134, 382389.

RD Nebes , MA Butters , BH Mulsant , BG Pollock , MD Zmuda , PR Houck , CF Reynolds (2000). Decreased working memory and processing speed mediate cognitive impairment in geriatric depression. Psychological Medicine 30, 679691.

P Neu , M Bajbouj , A Schilling , F Godemann , RM Berman , P Schlattmann (2005). Cognitive function over the treatment course of depression in middle-aged patients: correlation with brain MRI signal hyperintensities. Journal of Psychiatric Research 39, 129135.

JT O'Brien , A Lloyd , I McKeith , A Gholkar , N Ferrier (2004). A longitudinal study of hippocampal volume, cortisol levels, and cognition in older depressed subjects. American Journal of Psychiatry 161, 20812090.

RC Petersen , GE Smith , SC Waring , RJ Ivnik , EG Tangalos , E Kokmen (1999). Mild cognitive impairment: clinical characterization and outcome. Archives of Neurology 56, 303308.

MJ Portella , T Marcos , L Rami , V Navarro , C Gastó , M Salamero (2003). Residual cognitive impairment in late-life depression after a 12-month period follow-up. International Journal of Geriatric Psychiatry 18, 571576.

S Reppermund , J Zihl , S Lucae , S Horstmann , S Kloiber , F Holsboer , M Ising (2007). Persistent cognitive impairment in depression: the role of psychopathology and altered hypothalamic-pituitary-adrenocortical (HPA) system regulation. Biological Psychiatry 62, 400406.

RM Sapolsky (2000). Glucocorticoids and hippocampal atrophy in neuropsychiatric disorders. Archives of General Psychiatry 57, 925935.

RM Sapolsky , LC Krey , BS McEwen (1986). The neuroendocrinology of stress and aging: the glucocorticoid cascade hypothesis. Endocrine Reviews 7, 284301.

I Schweitzer , V Tuckwell , D Ames , J O'Brien (2001). Structural neuroimaging studies in late-life depression: a review. World Journal of Biological Psychiatry 2, 8388.

YI Sheline , JL Price , SN Vaishnavi , MA Mintun , DM Barch , AA Epstein , CH Wilkins , AZ Snyder , L Couture , K Schechtman , RC McKinstry (2008). Regional white matter hyperintensity burden in automated segmentation distinguishes late-life depressed subjects from comparison subjects matched for vascular risk factors. American Journal of Psychiatry 165, 524532.

DC Steffens , CE Byrum , DR McQuoid , DL Greenberg , ME Payne , TF Blitchington , JR MacFall , KR Krishnan (2000). Hippocampal volume in geriatric depression. Biological Psychiatry 48, 301309.

J Stroop (1935). Studies of interference in serial verbal reactions. Journal of Experimental Psychology 18, 643662.

AJ Thomas , JT O'Brien (2008). Depression and cognition in older adults. Current Opinion in Psychiatry 21, 8–13.

AJ Thomas , JT O'Brien , S Davis , C Ballard , R Barber , RN Kalaria , RH Perry (2002). Ischemic basis for deep white matter hyperintensities in major depression: a neuropathological study. Archives of General Psychiatry 59, 785792.

AU Turken , S Whitfield-Gabrieli , R Bammer , JV Baldo , NF Dronkers , JD Gabrieli (2008). Cognitive processing speed and the structure of white matter pathways: convergent evidence from normal variation and lesion studies. NeuroImage 42, 10321044.

P Weiland-Fiedler , K Erickson , T Waldeck , DA Luckenbaugh , D Pike , O Bonne , DS Charney , A Neumeister (2004). Evidence for continuing neuropsychological impairments in depression. Journal of Affective Disorders 82, 253258.

M Zimmerman , I Chelminski , M Posternak (2004). A review of studies of the Montgomery–Åsberg Depression Rating Scale in controls: implications for the definition of remission in treatment studies of depression. International Clinical Psychopharmacology 19, 17.

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