0710 The Association of Late-Life Depression, Cognitive Functioning, and Sleep Disorder in Aging

AbstractThis brief report provides an introduction to the topic of cognitive functioning in late-life depression (LLD). In addition to providing a review of the literature, we present a framework for understanding the heterogeneity of cognitive outcomes in this highly prevalent disorder. In addition, we discuss the relationship between LLD and dementia, and highlight the importance of regularly assessing cognitive functioning in older adults who present with depressive symptoms. If cognitive deficits are discovered during a neuropsychological assessment, we recommend referral to a geriatric psychiatrist or cognitive neurologist, for evaluation and treatment of the patient’s symptoms. (JINS, 2014, 20, 1–7)

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Association between physical frailty and cognition in late-life depression

European Psychiatry ◽

10.1016/j.eurpsy.2016.01.037 ◽

2016 ◽

Vol 33 (S1) ◽

pp. S84-S84

Author(s):

M. Arts ◽

R. Collard ◽

H. Comijs ◽

M. Zuidersma ◽

S. de Rooij ◽

...

Keyword(s):

Cognitive Impairment ◽

Cognitive Functioning ◽

Processing Speed ◽

Verbal Memory ◽

Late Life ◽

Interference Control ◽

Late Life Depression ◽

Physical Frailty ◽

Cognitive Frailty ◽

Frailty Criteria

IntroductionCognitive frailty has recently been defined as the co-occurrence of physical frailty and cognitive impairment. Late-life depression is associated with both physical frailty and cognitive impairment, especially processing speed and executive functioning.Aim and objectivesIn this study, we investigated the association between physical frailty and cognitive functioning in depressed older persons.MethodsIn a total of 378 patients (> 60 years) with depression according to DSM-IV criteria and a MMSE score of 24 points or higher, the physical frailty phenotype as well as its individual criteria (weight loss, weakness, exhaustion, slowness, low activity) was studied. Cognitive functioning was examined in 4 domains: verbal memory, working memory, interference control, and processing speed.ResultsOf the 378 depressed patients (range 60–90 years; 66.1% women), 61 were classified as robust (no frailty criteria present), 214 as prefrail (1 or 2 frailty criteria present), and 103 as frail (> 3 criteria). Linear regression analyses, adjusted for confounders, showed that the severity of physical frailty was associated with poorer verbal memory, slower processing speed, and decreased working memory, but not with changes in interference control.ConclusionIn late-life depression, physical frailty is associated with poorer cognitive functioning, although not consistently for executive functioning. Future studies should examine whether cognitive impairment in the presence of physical frailty belongs to cognitive frailty and is indeed an important concept to identify a specific subgroup of depressed older patients, who need multimodal treatment strategies integrating physical, cognitive, and psychological functioning.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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APOE is associated with age-of-onset, but not cognitive functioning, in late-life depression

International Journal of Geriatric Psychiatry ◽

10.1002/gps.1006 ◽

2003 ◽

Vol 18 (12) ◽

pp. 1075-1081 ◽

Cited By ~ 38

Author(s):

Meryl A. Butters ◽

Robert A. Sweet ◽

Benoit H. Mulsant ◽

M. Ilyas Kamboh ◽

Bruce G. Pollock ◽

...

Keyword(s):

Cognitive Functioning ◽

Age Of Onset ◽

Late Life ◽

Late Life Depression

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Change in Cognitive Functioning Following Acute Antidepressant Treatment in Late-Life Depression

American Journal of Geriatric Psychiatry ◽

10.1097/jgp.0b013e3181b4bf4a ◽

2009 ◽

Vol 17 (10) ◽

pp. 881-888 ◽

Cited By ~ 55

Author(s):

Michelle E. Culang ◽

Joel R. Sneed ◽

John G. Keilp ◽

Bret R. Rutherford ◽

Gregory H. Pelton ◽

...

Keyword(s):

Cognitive Functioning ◽

Antidepressant Treatment ◽

Late Life ◽

Late Life Depression

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Impaired Financial Capacity in Late-Life Depression: Revisiting Associations with Cognitive Functioning

Journal of the International Neuropsychological Society ◽

10.1017/s1355617719000705 ◽

2019 ◽

Vol 25 (10) ◽

pp. 1088-1093 ◽

Cited By ~ 5

Author(s):

Ruth T. Morin ◽

Mitzi M. Gonzales ◽

David Bickford ◽

Daniel Catalinotto ◽

Craig Nelson ◽

...

Keyword(s):

Cognitive Functioning ◽

Independent Living ◽

Rating Scale ◽

Late Life ◽

Executive Dysfunction ◽

Depression Severity ◽

Late Life Depression ◽

Cognitive Domains ◽

Financial Capacity ◽

Clinically Depressed

AbstractObjectives:Impairment in financial capacity is an early sign of cognitive decline and functional impairment in late life. Cognitive impairments such as executive dysfunction are well documented in late-life major depression; however, little progress has been made in assessing associations of these impairments with financial incapacity.Methods:Participants included 95 clinically depressed and 41 nondepressed older adults without dementia. Financial capacity (assessed with the Managing Money scale of the Independent Living Scale), cognitive functioning (comprehensive neuropsychological evaluation), and depression severity (Hamilton Depression Rating Scale – 24) were assessed. T tests were used to assess group differences. Linear regression was used to analyze data.Results:Depressed participants performed significantly lower on financial capacity (t = 2.98, p < .01). Among depressed participants, executive functioning (B = .24, p < .05) was associated with reduced financial capacity, controlling for age, gender, education, depression severity, and other cognitive domains.Conclusions:Our results underscore the importance of assessing financial capacity in older depressed adults as they are likely vulnerable to financial abuse even in the absence of dementia. It will be valuable to assess whether treatment for depression is an effective intervention to improve outcomes.

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Be Fit, Be Sharp, Be Well: The Case for Exercise as a Treatment for Cognitive Impairment in Late-life Depression

Journal of the International Neuropsychological Society ◽

10.1017/s1355617721000710 ◽

2021 ◽

pp. 1-14

Author(s):

Vonetta M. Dotson ◽

Andrew M. Gradone ◽

Hannah R. Bogoian ◽

Lex R. Minto ◽

Zinat Taiwo ◽

...

Keyword(s):

Cognitive Impairment ◽

Cognitive Functioning ◽

Antidepressant Treatment ◽

Late Life ◽

Poor Response ◽

Adjunctive Treatment ◽

Late Life Depression ◽

Research Findings ◽

Brain Changes ◽

Neurochemical Changes

Abstract Objective: To lay out the argument that exercise impacts neurobiological targets common to both mood and cognitive functioning, and thus more research should be conducted on its use as an alternative or adjunctive treatment for cognitive impairment in late-life depression (LLD). Method: This narrative review summarizes the literature on cognitive impairment in LLD, describes the structural and functional brain changes and neurochemical changes that are linked to both cognitive impairment and mood disruption, and explains how exercise targets these same neurobiological changes and can thus provide an alternative or adjunctive treatment for cognitive impairment in LLD. Results: Cognitive impairment is common in LLD and predicts recurrence of depression, poor response to antidepressant treatment, and overall disability. Traditional depression treatment with medication, psychotherapy, or both, is not effective in fully reversing cognitive impairment for most depressed older adults. Physical exercise is an ideal treatment candidate based on evidence that it 1) is an effective treatment for depression, 2) enhances cognitive functioning in normal aging and in other patient populations, and 3) targets many of the neurobiological mechanisms that underlie mood and cognitive functioning. Results of the limited existing clinical trials of exercise for cognitive impairment in depression are mixed but overall support this contention. Conclusions: Although limited, existing evidence suggests exercise may be a viable alternative or adjunctive treatment to address cognitive impairment in LLD, and thus more research in this area is warranted. Moving forward, additional research is needed in large, diverse samples to translate the growing research findings into clinical practice.

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Late-life depression symptom dimensions and cognitive functioning in the Longitudinal Aging Study Amsterdam (LASA)

Journal of Affective Disorders ◽

10.1016/j.jad.2016.05.027 ◽

2016 ◽

Vol 201 ◽

pp. 171-178 ◽

Cited By ~ 22

Author(s):

Anamaria Brailean ◽

Hannie C. Comijs ◽

Marja J. Aartsen ◽

Martin Prince ◽

A. Matthew Prina ◽

...

Keyword(s):

Cognitive Functioning ◽

Late Life ◽

Depression Symptom ◽

Late Life Depression ◽

Symptom Dimensions ◽

Longitudinal Aging Study Amsterdam ◽

Aging Study ◽

Longitudinal Aging Study

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Heterogeneity of late-life depression: relationship with cognitive functioning

International Psychogeriatrics ◽

10.1017/s1041610214000155 ◽

2014 ◽

Vol 26 (6) ◽

pp. 953-963 ◽

Cited By ~ 29

Author(s):

Nicole C. M. Korten ◽

Brenda W. J. H. Penninx ◽

Rob M. Kok ◽

Max L. Stek ◽

Richard C. Oude Voshaar ◽

...

Keyword(s):

Older Adults ◽

Working Memory ◽

Cognitive Functioning ◽

Psychotropic Medication ◽

Processing Speed ◽

Depressive Episode ◽

Late Life ◽

Late Life Depression ◽

Symptom Dimensions ◽

Cognitive Domains

ABSTRACTBackground:Late-life depression is a heterogeneous disorder, whereby cognitive impairments are often observed. This study examines which clinical characteristics and symptom dimensions of late-life depression are especially impacting on specific cognitive domains.Methods:Cross-sectional data of 378 depressed and 132 non-depressed older adults between 60–93 years, from the Netherlands Study of Depression in Older adults (NESDO) were used. Depressed older adults were recruited from both inpatient and outpatient mental healthcare institutes and general practices, and diagnosed according to DSM-IV-TR criteria. Multivariable associations were examined with depression characteristics (severity, onset, comorbidity, psychotropic medication) and symptom dimensions as independent variables and cognitive domains (episodic memory, processing speed, interference control, working memory) as dependent variables.Results:Late-life depression was associated with poorer cognitive functioning. Within depressed participants, higher severity of psychopathology and having a first depressive episode was associated with poorer cognitive functioning. The use of tricyclic antidepressants, serotonergic and noradrenergic working antidepressants, and benzodiazepines was associated with worse cognitive functioning. Higher scores on the mood dimension were associated with poorer working memory and processing speed, whereas higher scores on a motivational and apathy dimension were associated with poorer episodic memory and processing speed.Conclusions:Heterogeneity in late-life depression may lead to differences in cognitive functioning. Higher severity and having a first depressive episode was associated with worse cognitive performance. Additionally, different domains of cognitive functioning were associated with specific symptom dimensions. Our findings on the use of psychotropic medication suggest that close monitoring on cognitive side effects is needed.

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