The Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) has been studied relatively extensively in normal samples, and its theoretically derived index scores have been demonstrated to be useful in the assessment of a variety of clinical conditions. However, examinations of the empirical relationships between individual subtests are limited. The intent of the present study was to explore the component structure of the instrument in a sample of 351 individuals with a diagnosed memory disorder, to examine the impact of demographic factors on these empirically derived components, and to explore differences in performance between diagnostic groups. Findings suggested a three-component solution (Memory, Visuomotor Processing, and Verbal Processing). Demographic variables had relatively small, but significant relationships with various component scores. Significant differences were observed between probable Alzheimer's disease and non-Alzheimer's type dementia groups on the memory component score, but not on other component scores or on RBANS index scores.

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Background Investigate the longitudinal relationship between physical frailty, the clinical representation of accelerated biological aging, and antidepressant medication response in older adults with depressive illness. Methods An 8-week randomized placebo-controlled trial (escitalopram or duloxetine) followed by 10-months of open antidepressant medication treatment (augmentation, switch strategies) was conducted in an outpatient research clinic. 121 adults age > 60 years with Major Depressive (MDD) or Persistent Depressive Disorders and a 24-item Hamilton Rating Scale for Depression (HRSD) > 16 were enrolled. Primary measures assessed serially over 12-months include response (50% reduction from baseline HRSD score), remission (HRSD score < 10), and frailty (non/intermediate frail [0-2 deficits] vs frail [> 3 deficits]); latent class analysis was used to classify longitudinal frailty trajectories. Results A 2-class model best fit the data, identifying a consistently-low frailty-risk (63% of the sample) and consistently-high frailty-risk (37% of the sample) trajectory. Response and remission rates (P’s<.002) for adults in the high-risk frailty class were at least 21 percentage-points worse than those in the low-risk class over 12-months. Furthermore, subsequent frailty was associated with previous frailty (P’s < .01) but not previous response or remission (P’s > .10). Conclusions Antidepressant medication is poorly effective for MDD occurring in the context of frailty in older adults. Furthermore, even when an antidepressant response is achieved, this response does little to improve their frailty. These data suggest that standard psychiatric assessment of depressed older adults should include frailty measures and that novel therapeutic strategies to address comorbid frailty and depression are needed.

Objective: Late-life depression (LLD) is a chronic and heterogeneous disorder. Recent studies have implicated non-normative age-related processes in its pathogenesis. This investigation examined both cross-sectional and longitudinal associations between skeletal muscle mitochondrial function and LLD. Methods: Data from 603 men and women from the Baltimore Longitudinal Study on Aging were analyzed, of whom 167 provided data from a follow-up visit. Muscle bioenergetics was measured by postexercise recovery rate of phosphocreatine (PCr) using phosphorus magnetic resonance spectroscopy. Depressive symptoms were assessed using the Center for Epidemiologic Studies Depression (CES-D) Scale. Results: There was no cross-sectional association between baseline depression status and either the PCr recovery rate constant (kPCr; t= −0.553, df=542; p = 0.580) or mitochondrial capacity largely independent of exercise intensity (adenosine triphosphate maximum [ATP max ]; t = 0.804, df=553; p = 0.422). Covariate-adjusted Firth logistic regression models however showed that greater decreases in skeletal muscle mitochondrial function from baseline to follow-up were associated with higher odds of clinically significant depressive symptoms (CES-D 16) at follow-up (ΔATP max : odds ratio = 2.63, χ 2 = 5.62, df =1; p = 0.018; ΔkPCr: odds ratio = 2.32, χ 2 =5.79, df =1; p = 0.016). Conclusion: Findings suggest that declining skeletal muscle mitochondrial function in older adults is associated with clinically significant depressive symptoms at follow-up, thereby providing preliminary support for the hypothesis that mitochondrial dysfunction may be a

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