TY - JOUR
T1 - Cognitive Function in Late Life Depression
T2 - Relationships to Depression Severity, Cerebrovascular Risk Factors and Processing Speed
AU - Sheline, Yvette I.
AU - Barch, Deanna M.
AU - Garcia, Keith
AU - Gersing, Kenneth
AU - Pieper, Carl
AU - Welsh-Bohmer, Kathleen
AU - Steffens, David C.
AU - Doraiswamy, P. Murali
N1 - Funding Information:
YIS, DMB and KC are supported by a Collaborative R01 for Clinical Studies of Mental Disorders Grant Number MH60697. PMD, KG, KW-B, and CP are supported by a Collaborative R01 for Clinical Studies of Mental Disorders Grant Number MH62158. YIS also receives support from National Institute of Mental Health (NIMH) K24 65421 and DCS receives support from NIMH K24 70027. KW-B also receives support from National Institute on Aging (NIA) 05128 and NIA 11380. Additionally, this work was supported by a grant (RR00036) to the Washington University School of Medicine General Clinical Research Center.
PY - 2006/7/1
Y1 - 2006/7/1
N2 - Background: A number of studies have examined clinical factors linked to worse neuropsychological performance in late life depression (LLD). To understand the influence of LLD on cognition, it is important to determine if deficits in a number of cognitive domains are relatively independent, or mediated by depression- related deficits in a basic domain such as processing speed. Methods: Patients who met DSM-IV criteria for major depression (n = 155) were administered a comprehensive neuropsychological battery of tasks grouped into episodic memory, language, working memory, executive function, and processing speed domains. Multiple regression analyses were conducted to determine contributions of predictor variables to cognitive domains. Results: Age, depression severity, education, race and vascular risk factors all made significant and independent contributions to one or more domains of cognitive function, with all five making independent contributions to processing speed. Age of onset made no independent contribution, after accounting for age and vascular risk factors. Of the five cognitive domains investigated, changes in processing speed were found to most fully mediate the influence of predictor variables on all other cognitive domains. Conclusions: While slowed processing speed appears to be the most core cognitive deficit in LLD, it was closely followed by executive function as a core cognitive deficit. Future research is needed to help clarify mechanisms leading to LLD- related changes in processing speed, including the potential role of white matter abnormalities.
AB - Background: A number of studies have examined clinical factors linked to worse neuropsychological performance in late life depression (LLD). To understand the influence of LLD on cognition, it is important to determine if deficits in a number of cognitive domains are relatively independent, or mediated by depression- related deficits in a basic domain such as processing speed. Methods: Patients who met DSM-IV criteria for major depression (n = 155) were administered a comprehensive neuropsychological battery of tasks grouped into episodic memory, language, working memory, executive function, and processing speed domains. Multiple regression analyses were conducted to determine contributions of predictor variables to cognitive domains. Results: Age, depression severity, education, race and vascular risk factors all made significant and independent contributions to one or more domains of cognitive function, with all five making independent contributions to processing speed. Age of onset made no independent contribution, after accounting for age and vascular risk factors. Of the five cognitive domains investigated, changes in processing speed were found to most fully mediate the influence of predictor variables on all other cognitive domains. Conclusions: While slowed processing speed appears to be the most core cognitive deficit in LLD, it was closely followed by executive function as a core cognitive deficit. Future research is needed to help clarify mechanisms leading to LLD- related changes in processing speed, including the potential role of white matter abnormalities.
KW - age of onset
KW - cognitive deficit
KW - factor scores
KW - Late life depression
KW - neuropsychology
KW - vascular risk factors
UR - http://www.scopus.com/inward/record.url?scp=33745204385&partnerID=8YFLogxK
U2 - 10.1016/j.biopsych.2005.09.019
DO - 10.1016/j.biopsych.2005.09.019
M3 - Article
C2 - 16414031
AN - SCOPUS:33745204385
SN - 0006-3223
VL - 60
SP - 58
EP - 65
JO - Biological Psychiatry
JF - Biological Psychiatry
IS - 1
ER -