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

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.

Effects of between-person differences and within-person changes in symptoms of anxiety and depression on older age cognitive performance

“…An important finding of this study is that even rather modest intraindividual change in depression exerts significant influence on cognitive performance in the general population. Thus, our results extend the findings from a previous study targeting a population of depressed individuals (Dzierzewski et al 2015 ). The observed effects may reflect changes due to environmental factors, or feeling more happy or sad on a particular day.…”

“…The results have implications for the interpretation of cognitive test scores, as using scores based on only one occasion may give a somewhat misleading picture of that individual's actual cognitive abilities. The fluctuating nature of depression and its impact on cognitive performance may explain some of the inconsistencies in previous research concerning depressive symptoms and cognitive decline (Han et al 2006 ; Dzierzewski et al 2015 ). From a treatment perspective, the results from this study also show that when levels of depression go down, cognitive performance improves.…”

“…With regard to longitudinal associations, a large population-based study reported that the course of cognitive functioning was not significantly associated with the course of depressive symptoms (van den Kommer et al 2013 ), whereas a recent study observed that steeper decline in processing speed correlated with a steeper increase in depressive symptoms (Brailean et al 2017 ). In a sample of older adults with major depressive disorder, having more depressive symptoms than usual was associated with worse than average global cognitive function (Dzierzewski et al 2015 ). Here, we provide evidence that depressive symptoms covary with cognitive performance, especially letter fluency, in the general elderly population.…”

Geriatric Depression and Cognitive Impairment—An Update

“…A prospective study involving LOD patients ( n = 453) found increasing age, lower education status, and chronicity of depression as risk factors for poor cognitive performance. 27 Similarly, another prospective study noted a positive effect of education and a negative effect of cerebral comorbidity (stroke and Parkinson’s disease) on cognitive performance in LOD. 28 A systematic review of eight studies, which does not include previously mentioned studies, investigated the association between executive dysfunction and severity of depression in older adults.…”

Εκτίμηση Των Παραγόντων Που Προσδιορίζουν Τα Επίπεδα Και Πρότυπα Νοσηρότητας Σε Ευπαθείς Πληθυσμιακές Ομάδες Στην Ελλάδα Και Σε Άλλες Ευρωπαϊκές Χώρες Με Έμφαση Στην Ψυχική Υγεία

“…Ευρήματα άλλων ερευνητών επιβεβαιώνουν ότι η χαμηλή ή μέτρια αυτοαναφερόμενη υγεία συνδέεται με μεγαλύτερα odds εμφάνισης χρόνιων ασθενειών και καταθλιπτικών συμπτωμάτων (Ambresin et al, 2014;Kim, 2.8 Ανάλυση των δεδομένων κατά φύλο 48 2010). Αντίστοιχα, σε υγιή άτομα μεγάλης ηλικίας, αν παρουσιαστούν γνωστικές δυσλειτουργίες μπορούν να οδηγήσουν σε καταθλιπτικά συμπτώματα και ακόμα και σε άνοια στην περίπτωση που δεν αντιμετωπιστούν επιτυχώς μετά από κατάλληλη αγωγή (Dzierzewski et al, 2015;Wilkins et al, 2009). Η οικονομική εξασφάλιση των νοικοκυριών δίνει έναν αντισταθμιστικό παράγοντα καλύτερης ψυχικής υγείας και ευημερίας στην όψιμη ενήλικη ζωή.…”