Prediction of Antidepressant Efficacy by Cognitive Function in First-Episode Late-Life Depression: A Pilot Study

Abstract

The response rate of treatment for late-life depression (LLD) is only 25–60%. The cognitive impairment associated with LLD often affects the effectiveness of antidepressants and may has the potential ability to predict response. This study seeks a biomarker for baseline cognitive function to predict efficacy of antidepressants. Sixty patients diagnosed with LLD received escitalopram or sertraline treatment for 8 weeks. Clinical symptom was measured using Hamilton Depression Rating Scale-17 (HAMD-17) and cognitive function was measured using the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS), Trail Making Test (TMT) before and after 8-week treatment. Patients were divided into treatment effective group (TE) and treatment ineffective group (TI) according to reduction rate in scores of HAMD-17 after treatment. Thirty-eight matched healthy controls (HC) were assessed using RBANS and TMT. There was significant decrease of score of RBANS and increase of score of TMT in patients with LLD compared with HC. Regression analysis revealed that change in HAMD-17 score was significantly positively associated with baseline score of picture naming, figure copy, digit span, and delayed memory. The preliminary findings suggested that working memory, attention, visuospatial, language function, and delayed memory should be examined further as a means of providing the useful objective biomarkers of treatment response.Clinical Trials Registration[www.ClinicalTrials.gov], identifier [ChiCTR2100042370].

Altered topological properties of functional brain networks in patients with first episode, late-life depression before and after antidepressant treatment

“…In addition, no cases were diagnosed with additional Axis I major psychiatric disorders, except for anxiety disorders. Patients enrolled in the study had at least a score of 17 evaluated using the 17-item Hamilton depression rating scale (HAMD-17) (Pan et al, 2022 ). Age, sex, and education level-matched healthy controls (HCs) who had no history of mental disorders were recruited through internet advertisements.…”

Age or age of onset: which is the best criterion to classify late-life depression?

“…Cognitive impairment is one of the best characterised traits of LLD ( Masse et al , 2022 ) that has been associated with response and attrition during antidepressant treatment, as well as with suicidal behaviour ( Cristancho et al , 2018 ; Jordan et al , 2020 ; Lin et al , 2021 ; Pan et al , 2022 ). The degree of cognitive dysfunction was suggested to be higher in LOD in comparison with the EOD subtype ( Ly et al ., 2021 ).…”

Executive function deficits in patients with the first episode of late‐life depression before and after SSRI treatment: A pilot fMRI study

“…The diagnosis of LLD was confirmed by a certified geriatric psychiatrist through Axis I major depressive episode according to the DSM‐IV or DSM‐V through a diagnostic interview. Patients enrolled in the study had the least 17 scores evaluated using the 17‐item Hamilton Depression Rating Scale (HAMD) 28 . All participants were requested to achieve a minimum score of 24 on the Mini‐Mental State Examination Scale (MMSE) (excluding the presence of dementia) 29 .…”

“…Patients enrolled in the study had the least 17 scores evaluated using the 17-item Hamilton Depression Rating Scale (HAMD). 28 All participants were requested to achieve a minimum score of 24 on the Mini-Mental State Examination Scale (MMSE) (excluding the presence of dementia). 29 The exclusion criteria for all participants were major neurocognitive decline and head trauma history, Parkinson's disease, stroke, and critical cardiovascular, respiratory, immune, and other systemic diseases.…”