Cognitive dysfunction in depression: Difference between depressed and nondepressed elderly patients and differential cognitive effects of nomifensine

Abstract

The main aim of the study was to establish the degree of disturbance of the cognitive functions typical of the elderly depressed patients. The analysis was based on the results of a 4-week, double-blind, placebo-controlled therapeutic study in which the effects and tolerance of the antidepressant nomifensine were tested in a randomized group of 100 patients. Half the patients were depressed and half nondepressed (a priori stratification, HAM-D 2 18). Tests of central nervous arousal, attention, perceptual grouping, short-term and long-term memory, and complex reaction time were performed. The findings were analyzed as follows: First, baseline differences in cognitive performance, correlative of the stratification into depressed and nondepressed patients, were examined. Second, changes reflecting normalization of cognitive function resulting from the antidepressant treatment were analyzed. For antidepressant treatment, nomifensine, a noradrenaline and dopaminereuptake inhibitor, was used. Results showed that cognitive impairment in primary depression was fairly generalized over different cognitive functions. A global factor of cognitive impairment and a general cognitive improvement factor was found. Both factors are closely connected with the severity as well as the improvement in cardinal symptoms of depression. This relationship was interpreted as due to alterations in central nervous arousal.

Cognitive Function in the Affective Disorders: A Prospective Study

“…Confirming previous reports [25][26][27][28], this study shows that reversible cognitive impair ment may be present during acute episodes of either major depression or mania. Patients tended to perform worse than controls on conventional immediate and delayed recall tasks and on Benton Lines test, and to show more soft neurological signs than controls [29], On follow-up, these measures (except the Benton) were found to improve.…”

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“…In our own studies in depressed elderly patients Siegfried et al, 1984; Siegfried and O'Connolly, 1986;Siegfried, 1989) we found the following:…”

Incidence of depression in octo- and nonagenerians: results of an epidemiological follow-up community study

“…In addition to the GMS-A the Hamilton Depression Scale (HAMD; Hamilton 1967) was used for the assessment of depressive symptoms. Siegfried et al (1984) decided the following classification referring to the 21-item Hamilton Scale: Hamilton Score > 18 = depression; < 7 = no depression.…”

“…Therefore, the scale points were reduced from 63 to 55 points. The cutoffs of Siegfried et al (1984) were modified: Hamilton score > 16 = depression; < 6 = no depression; between 7 and 15 = no assessment.…”