How Late-Life Depression Affects Cognition: Neural Mechanisms

Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, 1695 Northwest 9th Avenue, Suite 3308, Miami, FL 33136, USA.
Current Psychiatry Reports (Impact Factor: 3.24). 02/2010; 12(1):34-8. DOI: 10.1007/s11920-009-0081-2
Source: PubMed


Late-life depression is a major health problem and a significant cause of dysfunction that warrants closer evaluation and study. In contrast to younger depressed patients, most depressed older adults suffer more severe variants of the disorder, including significant cognitive impairments. These cognitive changes add to the severity of symptoms and disability that older depressed patients face and likely reflect compromise of certain neural circuits, linking cognitive impairment to late-life depression. Studies examining clinical correlates, neuropsychological testing, and functional and anatomic imaging have yielded a clearer understanding of the neural mechanisms underlying cognitive deficits in late-life depression. This article discusses cognitive impairment in geriatric depression and how developing a better understanding of its neural correlates may lead to improved understanding and outcome of this specific disorder.

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    • "Both depression and cardiovascular diseases (CVDs) are risk factors for cognitive impairment [7], but the various neuropsychological mechanisms underlying LLD can lead to different patterns of cognitive impairment [8]. The current association between depression and cognitive impairment agrees with previous studies [9,10]. "
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    ABSTRACT: Whether depression or cardiovascular disease would have a greater effect on worsening cognitive impairment in the burgeoning older elderly population is uncertain. Which disorder causes greater cognitive impairment was investigated. A cross section of 207 cognitively impaired older elderly (>=75 years old) men was recruited from outpatient clinics in southern Taiwan between 2004 and 2008. Their medical charts were reviewed for their history of medical illnesses, and those undergoing a current major depressive episode were screened using the Mini-International Neuropsychiatric Interview. Four groups of men were enrolled: 33 healthy controls (HC), 101 cognitively impaired patients with cardiovascular comorbidities (CVCs), 34 patients with late-life depression (LLD), and 49 patients with LLD and cardiovascular comorbidities (LLD + CVC). Several neuropsychological tests (e.g., Mini-Mental State Examination (MMSE), WCST, and Trail Making Test (TMT) parts A and B) were used to assess the participants. Cognitive function scores were highest in the HC group and lowest in the LLD + CVC group. There were no significant differences between the two groups with LLD comorbidity, and LLD was mostly associated with cognitive performance. LLD + CVC group members had the lowest recall memory, but their overall MMSE score was not significantly different. Moreover, this group had a higher but nonsignificantly different perseverative error than did the LLD group. Similarly, the LLD + CVC group was nonsignificantly slower at the TMT-A and TMT-B tasks than was the LLD group. LLD worsens neuropsychological function more than cardiovascular comorbidities do.
    Full-text · Article · Nov 2013 · Annals of General Psychiatry
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    • "Depression in persons with CogI is marked by abnormalities on neuropsychological tests [44] including impairments in memory, attention, and executive function, such as problem solving (for a review see [45]). Patients with major depressive disorder continue to show deficits in attention and executive function even after remission [46]. "
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    ABSTRACT: Prevalence studies have noted the cooccurrence of cognitive decline and depression in persons with heart failure. Cognitive impairment is associated with significant mortality and deteriorated quality of life, likely due to impairments in memory and executive function, which impact a patient's ability to understand and comply with prescribed treatment plans. This is especially true in complex diseases such as heart failure. Evidence from literature supports the possibility of a pathophysiological relationship between cognitive impairment, depression, and heart failure. Yet, very few studies have sought to investigate this relationship. This paper reviews current literature on the association between depression and cognitive impairment in persons with heart failure and explores possible mechanisms explaining this complex triad.
    Full-text · Article · Aug 2012 · Cardiology Research and Practice
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    • "l›nmam›fl olmas›na karfl›n, bâz› hastalar›n biliflsel yetilerinin kötü oldu¤u tesbit edilmifltir. Geriye dönük bir inceleme yap›ld›¤› için depresyonu olan tüm hastalar›n biliflsel ifllevleri de¤erlendirilememifltir. Yafll›l›k dönemi depresyonunda yürütücü ifllevler, bellek ve dikkat bozukluklar›n›n olabilece¤i bilinmektedir (Lockwood ve ark. 2002, Crocco ve ark. 2010). SMMT kolay uygulanabilen ve biliflsel kay›plar konusunda kabaca fikir veren bir testtir. Çal›flmam›zda, e¤itim y›l› ile SMMT puanlar› aras›nda pozitif korelasyon sap- New/Yeni Symposium Journal •"

    Full-text · Article · Jan 2012 · Yeni Symposium
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