Depression and cognitive impairment in older adults

Current Psychiatry Reports

Volumn 14, Issue 4, 2012, Pages 280-288

  Weisenbach, Sara L ^a,b   Boore, Laurie A ^a   Kales, Helen C ^a,b  

^a UNIVERSITY OF MICHIGAN MEDICAL SCHOOL   (United States)

^b VA ANN ARBOR HEALTHCARE SYSTEM   (United States)

Author keywords

Cognition; Dementia; Elderly; Interventions for cognitive impairment; Late life depression; LLD; Mechanisms of cognitive deficits; Neuropsychological abnormalities; Treatment resistance

Indexed keywords

ARTICLE; BRAIN FUNCTION; BRAIN SIZE; CLINICAL FEATURE; COGNITIVE DEFECT; COGNITIVE THERAPY; DEMENTIA; DISEASE ASSOCIATION; DISEASE COURSE; EXECUTIVE FUNCTION; FUNCTIONAL MAGNETIC RESONANCE IMAGING; GRAY MATTER; HUMAN; LATE LIFE DEPRESSION; MENTAL PERFORMANCE; NEUROPATHOLOGY; NEUROPSYCHOLOGICAL TEST; PATIENT IDENTIFICATION; PROBLEM SOLVING; PROGNOSIS; PSYCHOEDUCATION; RISK FACTOR; SLEEP DISORDER;

AGE OF ONSET; AGED; AGED, 80 AND OVER; COGNITION DISORDERS; COMORBIDITY; DEMENTIA, VASCULAR; DEPRESSIVE DISORDER; HUMANS; NEUROPSYCHOLOGICAL TESTS; RISK FACTORS;

EID: 84865643070     PISSN: 15233812     EISSN: 15351645     Source Type: Journal    
DOI: 10.1007/s11920-012-0278-7     Document Type: Article

References (67)

1. Hall JR,O'Bryant SE, Johnson LA, Barber RC, Depressive symptom clusters and neuropsychological performance in mild Alzheimer's and cognitively normal elderly. Depress Res Treat. 2011;2011: 396958.
2. Yeh YC, Tsang HY, Lin PY, et al. Subtypes of mild cognitive impairment among the elderly with major depressive disorder in remission. Am J Geriatr Psychiatry. 2011;19:923-931. Reduced performance on measures of information processing speed and memory were independently associated with remitted LLD. Those with aMCI were more likely to have late-onset depression and ventricular atrophy, while those with naMCI had a greater degree of vascular burden.
3. Alexopoulos GS, Meyers BS, Young RC. The course of geriatric depression with "reversible dementia": a controlled study. Am J Psychiatry. 1993;150:1693-9. (Pubitemid 23325953)
4. Baudic S, Tzortzis C, Barba GD, Traykov L. Executive deficits in elderly patients with major unipolar depression. J Geriatr Psychiatry Neurol. 2004:17:195-201. (Pubitemid 40515138)
5. Butters MA, Whyte EM, Nebes RD et al. The nature and determinants of neuropsychological functioning in late-life depression. Arch Gen Psychiatry. 2004;61:587-95. (Pubitemid 38747313)
6. Elderkin-Thompson V, Mintz J, Haroon E, et al. Executive dysfunction and memory in older patients with major and minor depression. Arch Clin Neuropsychol. 2007;22:261-70. (Pubitemid 46356886)
7. Bhalla RK, Butters MA, Mulsant BH, et al. Persistence of neuropsychologic deficits in the remitted state of late-life depression. Am J Geriatr Psychiatry. 2006;14:419-427.
8. Wright SL, Persad C. Distinguishing between depression and dementia in older persons: neuropsychological and neuropathological correlates. J Geriatr Psychiatry Neurol. 2007;20:189-98. (Pubitemid 350077300)
9. Dillon C, Machnicki G, Serrano CM et al. Clinical manifestations of geriatric depression in a memory clinic: toward a proposed subtyping of geriatric depression. J Affect Disord. 2011;134:177-87.
10. Elderkin-Thompson V, Moody T, Knowlton B, et al. Explicit and implicit memory in late-life depression. Am J Geriatr Psychiatry. 2011;19:249-55. MDD patients had a poorer performance than controls on indices of executive function, attention, and processing speed, as well as on measures of verbal learning and verbal and nonverbal recall, but not on measures of memory recognition or retention, implicit learning, or language fluency.
11. Potter GG, McQuoid DR, Payne ME, et al. Association of attentional shift and reversal learning to functional deficits in geriatric depression. Int J Geriatr Psychiatry. 2012;doi:10.1002/gps.3764. Attentional shifting in depressed older adults is associated with selfreported performance in instrumental activities of daily living.
12. Yen YC, Rebok GW, Gallo JJ, et al. Depressive symptoms impair everyday problem-solving ability through cognitive abilities in late life. Am J Geriatr Psychiatry. 2011:19:142-50. Depressive symptoms are associated with everyday problem-solving and are mediated by learning and memory as well as reasoning skills.
13. Benitez A, Horner MD, Bachman D. Intact cognition in depressed elderly veterans providing adequate effort. Arch Clin Neuropsychol. 2011;26:184-93.
14. Yesavage JA, Brink TL, Rose TL, et al. Development and validation of a geriatric depression screening scale: a preliminary report. J Psychiatr Res. 1982;17:37-49. (Pubitemid 13123113)
15. Tombaugh TN. Test of memory malingering. North Tonawanda, New York; 1996.
16. Randolph C: Repeatable battery for the assessment of neuropsychological status. San Antonio, TX: Pearson; 1998.
17. Naismith SL, Rogers NL, Lewis SJ, et al. Sleep disturbance relates to neuropsychological functioning in late-life depression. J Affect Disord. 2011:132:139-45.
18. Sanders JB, Bremmer MA, Comijs HC, et al. Cognitive functioning and the natural course of depressive symptoms in late life. Am J Geriatr Psychiatry. 2011:19:664-72. Processing speed is independently associated with a chronic course of depression, but not a remitting or fluctuating course of depression, after controlling for vascular risk factors.
19. Morimoto SS, Gunning FM, Kanellopoulos D, et al. Semantic organizational strategy predicts verbal memory and remission rate of geriatric depression. Int J Geriatr Psychiatry. 2012;27:506-12. Performance on a measure of semantic fluency positively predicted remission of depressive symptoms over 12 weeks of treatment with escitalopram.
20. Potter GG, Kittinger JD, Wagner HR, et al. Prefrontal neuropsychological predictors of treatment remission in late-life depression. Neuropsychopharmacology. 2004;29:2266-71. (Pubitemid 39578919)
21. Jorm AF. Is depression a risk factor for dementia or cognitive decline? Gerontology. 2000;46:219-27. (Pubitemid 30422228)
22. Chan WC, Lam LC, Tam CW, et al. Neuropsychiatric symptoms are associated with increased risks of progression to dementia: a 2-year prospective study of 321 Chinese older persons with mild cognitive impairment. Age Ageing. 2011;40:30-5. Of all neuropsychiatric symptoms assessed at baseline, only depression was demonstrated to be a risk factor for progression to dementia over 2 years, with an odds ratio of 2.40.
23. Goveas JS, Hogan PE, Kotchen JM, et al. Depressive symptoms, antidepressant use, and future cognitive health in postmenopausal women: the Women's Health Initiative Memory Study. Int Psychogeriatr. 2012;17:1-13. A study of 6,376 postmenopausal women without cognitive impairment at baseline that identified a nearly two-fold greater risk of MCI and incident dementia during approximately 5.5 year follow-up among women with a history of depressive symptoms after adjustment for potential confounds.
24. Gunning-Dixon FM, Hoptman MJ, Lim KO, et al. Macromolecular white matter abnormalities in geriatric depression: a magnetization transfer imaging study. Am J Geriatr Psychiatry. 2008;16:255-62.
25. Bae JN, MacFall JR, Krishnan KR, et al. Dorsolateral prefrontal cortex and anterior cingulate cortex white matter alterations in latelife depression. Biol Psychiatry. 2006;1356-63. (Pubitemid 44838529)
26. Hanfelt JJ, Wuu J, Sollinger AB, et al. An exploration of subgroups of mild cognitive impairment based on cognitive, neuropsychiatric and functional features: analysis of data from the national Alzheimer's coordinating center. Am J Geriatr Psychiatry. 2011;19:940-50.
27. Hajjar I, Quach L, Yang F, et al. Hypertension, white matter hyperintensities, and concurrent impairments in mobility, cognition, and mood: the Cardiovascular Health Study. Circulation. 2011;123:858-65. Among 4,700 subjects, hypertension at baseline increased the risk of concurrent impairments in mobility, cognition, and mood, which in turn increased the risk of disability and mortality over 12 years.
28. Schneider B, Ercoli L, Siddarth P, Lavretsky H. Vascular burden and cognitive functioning in depressed older adults. Am J Geriatr Psychiatry. 2011;doi:10.1097/JGP.0b013e31822ccd64. After controlling for depression severity, cardiovascular risk factors were associated with cognitive control and attention, but not memory or verbal fluency among 94 community-dwelling LLD patients.
29. Sexton CE, McDermott L, Kalu UG, et al. Exploring the pattern and neural correlates of neuropsychological impairment in late-life depression. Psychol Med. 2012;42:1195-202. Among patients with LLD, slowed processing speed was related to reduced white matter integrity of the genu of the corpus callosum, while poor episodic memory was correlated with reduced white matter integrity of the anterior thalamic radiation, body and genu of the corpus callosum, and the fornix.
30. Ballmaier M, Toga AW, Blanton RE, et al. Anterior cingulate, gyrus rectus, and orbitofrontal abnormalities in elderly depressed patients: an MRI-based parcellation of the prefrontal cortex. Am J Psychiatry. 2004;161:99-108. (Pubitemid 38419314)
31. Ballmaier M, Narr K, Toga A, et al. Hippocampal morphology and distinguishing late-onset from early-onset elderly depression. Am J Psychiatry. 2008;165:229-37. (Pubitemid 351704523)
32. Egger K, Schocke M, Weiss E, et al. Pattern of brain atrophy in elderly patients with depression revealed by voxel-based morphometry. Psychiatry Res. 2008;164:237-44.
33. Hwang JP, Lee TW, Tsai SJ, et al. Cortical and subcortical abnormalities in late-onset depression with history of suicide attempts investigated with MRI and voxel-based morphometry. J Geriatr Psychiatry. Neurol 2010;23:171-84.
34. Janssen J, Hulshoff Pol HE, de Leeuw FE, et al.: Hippocampal volume and subcortical white matter lesions in late life depression: comparison of early and late onset depression. J Neurol Neurosurg Psychiatry. 2007;78:638-40. (Pubitemid 46853904)
35. Lim HK, Jung WS, Ahn KJ, et al. Regional cortical thickness and subcortical volume changes are associated with cognitive impairments in the drug-naive patients with late-onset depression. Neuropsychopharmacology. 2012;37:838-49. Patients with LLD had reduced cortical thickness in a number of frontal, temporal, and parietal regions relative to controls, as well as decreased hippocampal volume. Cortical thickness and hippocampal volume were related to performance on measures of memory and executive functioning.
36. Hutton C, Draganski B, Ashburner J, Weiskopf N. A comparison between voxel-based cortical thickness and voxel-based morphometry in normal aging. Neuroimage. 2009;48:371-80.
37. Steffens DC, McQuoid DR, Payne ME, Potter GG: Change in hippocampal volume on magnetic resonance imaging and cognitive decline among older depressed and nondepressed subjects in the neurocognitive outcomes of depression in the elderly study. Am J Geriatr Psychiatry. 2011;19:4-12. In patients with LLD there was a greater decrease in left hippocampal volume over 2 years, relative to controls. Reduction in hippocampal volume bilaterally during the 2-year period among LLD patients was associated with a subsequent decline in performance on the MMSE, with no significant associations demonstrated for controls.
38. Hou Z, Yuan Y, Zhang Z, et al. Longitudinal changes in hippocampal volumes and cognition in remitted geriatric depressive disorder. Behav Brain Res. 2012;227:30-5. Remitted LLD patients had smaller bilateral hippocampal volume at baseline relative to controls, although right volume increased over the 21-month follow-up, and this was related to improved performance on a brief measure of executive functioning, processing speed, and attention. Decrease in the left hippocampal volume was related to a decline in MMSE score.
39. Erickson KI, Miller DL, Roecklein KA. The aging hippocampus: interactions between exercise, depression, and BDNF. Neuroscientist. 2012;18:82-97.
40. Apostolova LG, Dutton RA, Dinov ID, et al. Conversion of mild cognitive impairment to Alzheimer disease predicted by hippocampal atrophy maps. Arch Neurol. 2006;63:693-699.
41. Aizenstein HJ, Butters MA, Figurski JL, et al. Prefrontal and striatal activation during sequence learning in geriatric depression. Biol Psychiatry. 2005;58:290-6. (Pubitemid 41133622)
42. Aizenstein HJ, Butters MA, Wu M, et al. Altered functioning of the executive control circuit in late-life depression: episodic and persistent phenomena. Am J Geriatr Psychiatry. 2009:17:30-42.
43. Brassen S, Kalisch R, Weber-Fahr W, et al. Ventromedial prefrontal cortex processing during emotional evaluation in late-life depression: a longitudinal functional magnetic resonance imaging study. Biol Psychiatry. 2008;64:349-55.
44. Wang L, Potter GG, Krishnan RK, et al. Neural correlates associated with cognitive decline in late-life depression. Am J Geriatr Psychiatry. 2011;doi:10.1097/JGP.0b013e31823e2cc7. In LLD patients, decreased activation during target detection in the anterior cingulate cortex, hippocampus, inferior frontal cortex, and insula was associated with persistent cognitive impairment at 2-year follow-up.
45. Aizenstein HJ, Andreescu C, Edelman KL, et al. fMRI correlates of white matter hyperintensities in late-life depression. Am J Psychiatry. 2011;168:1075-82. White matter hyperintensity burden in LLD patients (but not controls) predicted greater BOLD response in the rostral anterior cingulate during face emotion processing.
46. Biswal B, Yetkin FZ, Haughton VM, Hyde JS. Functional connectivity in the motor cortex of resting human brain using echo-planar MRI. Magn Reson Med. 1995;34:537-41.
47. Cordes D, Haughton VM, Arfanakis K, et al. Mapping functionally related regions of brain with functional connectivity MR imaging. AJNR Am J Neuroradiol. 2000;21:1636-44.
48. Lowe MJ, Mock BJ, Sorenson JA. Functional connectivity in single and multislice echoplanar imaging using resting-state fluctuations. Neuroimage. 1998;7:119-32. (Pubitemid 28355547)
49. Wang L, Krishnan KR, Steffens DC, et al. Depressive state-and disease-related alterations in neural responses to affective and executive challenges in geriatric depression. Am J Psychiatry. 2008; 165:863-871. (Pubitemid 351948718)
50. Yuan Y, Zhang Z, Bai F, et al. Abnormal neural activity in the patients with remitted geriatric depression: a resting-state functional magnetic resonance imaging study. J Affect Disord. 2008;111:145-52.
51. Hamilton M. The assessment of anxiety states by rating. Br J Med Psychol. 1959;32:50-5.
52. Derogatis LR. Brief symptom inventory. San Antonio, TX: Pearson; 1993.
53. Raichle ME, MacLeod AM, Snyder AZ, et al. A default mode of brain function. Proc Natl Acad Sci USA. 2001;98:676-82. (Pubitemid 32105102)
54. Andreescu C, Wu M, Butters MA, et al. The default mode network in late-life anxious depression. Am J Geriatr Psychiatry. 2011;19:980-3. Highly anxious LLD patients demonstrated greater functional connectivity between posterior cingulate and posterior regions of the default mode network compared with mildly anxious LLD patients.
55. Stoodley CJ. The cerebellum and cognition: evidence from functional imaging studies. Cerebellum. 2011;doi:10.1007/s12311-011-0260-7.
56. Alalade E, Denny K, Potter G, et al. Altered cerebellar-cerebral functional connectivity in geriatric depression. PLoS One 2011;6: e20035. LLD patients had altered connectivity among executive, default mode, affective-limbic, and motor cerebellar networks and cerebral regions important to these functions.
57. Goveas J, Xie C, Wu Z, et al. Neural correlates of the interactive relationship between memory deficits and depressive symptoms in nondemented elderly: resting fMRI study. Behav Brain Res. 2011;219:205-12. Poorer memory performance was associated with decreased hippocampal functional networks, while negative relationships were found between depression severity and connectivity of the hippocampus with positively correlated hippocampal networks. There was additionally an interaction between depression symptom severity and memory performance in connectivity between hippocampus and specific frontal, temporal, and parietal regions.
58. Xie C, Goveas J, Wu Z, et al. Neural basis of the association between depressive symptoms and memory deficits in nondemented subjects: resting-state fMRI study. Hum Brain Mapp. 2012;33:1352-63. A study of functional connectivity of the amygdala with other cortical regions, suggesting that there might be independent networks associated with emotion and memory, in addition to the interactive effects of depressive symptoms and memory functions on functional connectivity.
59. Delrieu J, Piau A, Caillaud C, et al. Managing cognitive dysfunction through the continuum of Alzheimer's disease: role of pharmacotherapy. CNS Drugs. 2011;25:213-26.
60. Naismith SL, Diamond K, Carter PE, et al. Enhancing memory in late-life depression: the effects of a combined psychoeducation and cognitive training program. Am J Geriatr Psychiatry. 2011;19:240-8. Patients with a lifetime history of depression assigned to 10 weeks of psychoeducation and computerized cognitive training displayed improved performance following treatment on tests of visual memory and verbal memory retention, but not executive functioning, relative to wait-list controls.
61. Kessing LV, Forman JL, Andersen PK. Do continued antidepressants protect against dementia in patients with severe depressive disorder? Int Clin Psychopharmacol. 2011;26:316-22. Among depressed patients following discharge from psychiatric hospital, there was a decreased rate of dementia and Alzheimer's disease during periods of two or more prescriptions of older antidepressants, compared with a period of one prescription of older antidepressants. During periods of continued use of SSRIs or newer non-SSRIs, the rate of dementia did not decrease.
62. Alexopoulos GS, Raue PJ, Kanellopoulos D, et al. Problem solving therapy for the depression-executive dysfunction syndrome of late life. Int J Geriatr Psychiatry. 2008;23:782-8.
63. Alexopoulos GS, Raue P, Arean P. Problem-solving therapy versus supportive therapy in geriatric major depression with executive dysfunction. Am J Geriatr Psychiatry. 2003;11:46-52. (Pubitemid 36091342)
64. Arean P, Hegel M, Vannoy S, et al. Effectiveness of problemsolving therapy for older, primary care patients with depression: results from the IMPACT project. Gerontologist. 2008;48:311-23. (Pubitemid 351961678)
65. Gellis ZD, McGinty J, Horowitz A, et al. Problem-solving therapy for late-life depression in home care: a randomized field trial. Am J Geriatr Psychiatry. 2007;15:968-78.
66. Devanand DP, Adorno E, Cheng J, et al. Late onset dysthymic disorder and major depression differ from early onset dysthymic disorder and major depression in elderly outpatients. J Affect Disord. 2004;78:259-67. (Pubitemid 38167746)
67. Drachmann Bukh J, Bock C, Vinberg M, et al. Differences between early and late onset adult depression. Clin Pract Epidemiol Ment Health. 2011;7:140-7. Patients with early onset of depression had a higher prevalence of co-morbid personality disorders, higher levels of neuroticism, and a lower prevalence of stressful life events preceding onset relative to those with a late onset of depression.