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

Lookup NU author(s): Sebastian Kohler, Professor Alan Thomas, Nicola Barnett, Professor John O'Brien

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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.


Publication metadata

Author(s): Köhler S, Thomas AJ, Barnett NA, O'Brien JT

Publication type: Article

Publication status: Published

Journal: Psychological Medicine

Year: 2010

Volume: 40

Issue: 4

Pages: 591-602

Date deposited: 27/07/2010

ISSN (print): 0033-2917

ISSN (electronic): 1469-8978

Publisher: Cambridge University Press

URL: http://dx.doi.org/10.1017/S0033291709990833

DOI: 10.1017/S0033291709990833


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