Cognitive functioning throughout the treatment history of clinical late-life depression

Joseph M Dzierzewski; Guy G Potter; Richard N Jones; Ola S Rostant; Brian Ayotte; Frances M Yang; Bonnie C Sachs; Betsy J Feldman; David C Steffens

doi:10.1002/gps.4264

Cognitive functioning throughout the treatment history of clinical late-life depression

Int J Geriatr Psychiatry. 2015 Oct;30(10):1076-84. doi: 10.1002/gps.4264. Epub 2015 Feb 20.

Authors

Joseph M Dzierzewski^{1

2}, Guy G Potter³, Richard N Jones⁴, Ola S Rostant⁵, Brian Ayotte⁶, Frances M Yang⁷, Bonnie C Sachs⁸, Betsy J Feldman⁹, David C Steffens¹⁰

Affiliations

¹ David Geffen School of Medicine, UCLA, Los Angeles, CA, USA.
² Geriatric Research, Education and Clinical Center, Greater Los Angeles Veterans Affairs Healthcare System, Los Angeles, CA, USA.
³ Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA.
⁴ Department of Psychiatry and Human Behavior, Warren Alpert Medical School, Brown University, Providence, RI, USA.
⁵ National Institute on Aging, Intramural Research Program, National Institutes of Health and Department of Psychiatry, University of Michigan, Anne Arbor, MI, USA.
⁶ Department of Psychology, University of Massachusetts Dartmouth, Dartmouth, MA, USA.
⁷ Department of Biostatistics and Epidemiology, Medical College of Georgia, Georgia Regents University, Augusta, GA, USA.
⁸ Department of Neurology, Wake Forest University Baptist Medical Center, Winston-Salem, NC, USA.
⁹ Partners for Children, School of Social Work, University of Washington, Seattle, WA, USA.
¹⁰ Department of Psychiatry, University of Connecticut, Farmington, CT, USA.

Abstract

Objective: Previous investigations into the relationship between late-life depressive symptoms and cognitive functioning have resulted in mixed findings concerning whether or not depressive symptoms and cognitive functioning are related. The mixed reports may be due in part to differences in clinical and nonclinical samples and to inadequate consideration of the dynamic nature (i.e., fluctuating course) of depressive symptoms and cognitive functioning in older adults. The current study examined the chronic, acute, and longitudinal relationships between depressive symptoms and cognitive functioning in older adults in an ongoing treatment study of major depressive disorder (MDD).

Methods: The neurocognitive outcomes of depression in the elderly study operates in a naturalistic treatment milieu using a pharmacological treatment algorithm and regular psychiatric assessment. Four hundred and fifty-three older adults [mean age 70 years, standard deviation (SD) = 7.2] meeting criteria for MDD at study enrollment received annual neuropsychological testing and depressive symptom monitoring for an average of 8.5 years (SD = 4.5).

Results: Hierarchical linear modeling revealed that higher age, lower education, and higher average/chronic levels of depressive symptoms were related to lower cognitive functioning. Additionally, results revealed that when an individual's depressive symptoms are higher than is typical for a specific individual, general cognitive function was worse than average. There was no evidence of lagged/longitudinal relationships between depressive symptoms and cognitive functioning in older adults in treatment for MDD.

Conclusions: Cognitive functioning and depressive symptoms are concurrently associated in older adults with MDD, highlighting the potential importance for stabilizing mood symptoms as a means to manage cognitive deficits in late-life depression.

Keywords: cognitive functioning; depressive symptoms; longitudinal design; major depressive disorder; naturalistic study.

Publication types

Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

Age of Onset
Aged
Aged, 80 and over
Cognition / physiology*
Cognition Disorders / complications
Cognition Disorders / psychology*
Depressive Disorder, Major / complications
Depressive Disorder, Major / physiopathology
Depressive Disorder, Major / psychology*
Female
Humans
Longitudinal Studies
Male
Middle Aged
Neuropsychological Tests

Abstract

Publication types

MeSH terms

Grants and funding