Hostname: page-component-8448b6f56d-sxzjt Total loading time: 0 Render date: 2024-04-19T11:03:56.665Z Has data issue: false hasContentIssue false
  • English
  • Français

Heterogeneity of late-life depression: relationship with cognitive functioning

Published online by Cambridge University Press:  24 February 2014

Nicole C. M. Korten ,
Brenda W. J. H. Penninx ,
Rob M. Kok ,
Max L. Stek ,
Richard C. Oude Voshaar ,
Dorly J. H. Deeg  and
Hannie C. Comijs
Nicole C. M. Korten*
Affiliation:
Department of Epidemiology and Biostatistics and the EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, the Netherlands
Brenda W. J. H. Penninx
Affiliation:
Department of Psychiatry and the EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, the Netherlands
Rob M. Kok
Affiliation:
Department of Old Age Psychiatry, Parnassia Psychiatric Institute, The Hague, the Netherlands
Max L. Stek
Affiliation:
Department of Psychiatry and the EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, the Netherlands
Richard C. Oude Voshaar
Affiliation:
University Center of Psychiatry & Interdisciplinary Center of Psychiatric Epidemiology, University Medical Center Groningen, The University of Groningen and Department of Psychiatry, Radboud University Nijmegen Medical Center, Nijmegen, the Netherlands
Dorly J. H. Deeg
Affiliation:
Department of Epidemiology and Biostatistics and the EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, the Netherlands
Hannie C. Comijs
Affiliation:
Department of Psychiatry and the EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, the Netherlands
*
Correspondence should be addressed to: Nicole C.M. Korten, M.Sc., VU University Medical Center, van der Boechorststraat 7, 1081 BT Amsterdam, the Netherlands. Phone: +31-20-444-9327; Fax: +31-20-444-6775. Email: n.korten@vumc.nl.
Get access Rights & Permissions [Opens in a new window]

Abstract

Background:

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.

Keywords

late-life depressioncognitionclinical characteristicssymptom dimensions
Type
Research Article
Information
International Psychogeriatrics , Volume 26 , Issue 6 , June 2014 , pp. 953 - 963
Copyright
Copyright © International Psychogeriatric Association 2014 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Baune, B. T., Suslow, T., Arolt, V. and Berger, K. (2007). The relationship between psychological dimensions of depressive symptoms and cognitive functioning in the elderly – the MEMO-study. Journal of Psychiatric Research, 41, 247–254. doi:10.1016/j.jpsychires.2006.06.004.Google Scholar
Beaudreau, S. A. and O'Hara, R. (2008). Late-life anxiety and cognitive impairment: a review. The American Journal of Geriatric Psychiatry, 16, 790–803. doi:10.1097/JGP.0b013e31817945c3 CrossRefGoogle ScholarPubMed
Beck, A. T., Epstein, N., Brown, G. and Steer, R. A. (1988). An inventory for measuring clinical anxiety: psychometric properties. Journal of Consulting and Clinical Psychology, 56, 893–897. doi:10.1037/0022-006X.56.6.893.Google Scholar
Bierman, E. J. M., Comijs, H. C., Jonker, C. and Beekman, A. T. F. (2005). Effects of anxiety versus depression on cognition in later life. The American Journal of Geriatric Psychiatry, 13, 686–693.Google Scholar
Bierman, E. J. M., Comijs, H. C., Gundy, C. M., Sonnenberg, C., Jonker, C. and Beekman, A. T. F. (2007). The effect of chronic benzodiazepine use on cognitive functioning in older persons: good, bad or indifferent? International Journal of Geriatric Psychiatry, 22, 1194–1200. doi:10.1002/gps.1811.Google Scholar
Butters, M. A. (2004). The nature and determinants of neuropsychological functioning in late-life depression. Archives of General Psychiatry, 61, 587. doi:10.1001/archpsyc.61.6.587.CrossRefGoogle ScholarPubMed
Comijs, H. C. et al. (2011). The Netherlands study of depression in older persons (NESDO); a prospective cohort study. BMC Research Notes, 4, 524.Google Scholar
Comijs, H. C., Aartsen, M. J., Visser, M. and Deeg, D. J. H. (2012). Alcoholgebruik onder 55-plussers in Nederland. Tijdschrift voor Gerontologie en Geriatrie, 43, 115–126. doi:10.1007/s12439-012-0018-9.Google Scholar
DeLuca, A. K. et al. (2005). Comorbid anxiety disorder in late life depression: association with memory decline over four years. International Journal of Geriatric Psychiatry, 20, 848–854. doi:10.1002/gps.1366.Google Scholar
Dotson, V. M., Beydoun, M. A. and Zonderman, A. B. (2010). Recurrent depressive symptoms and the incidence of dementia and mild cognitive impairment. Neurology, 75, 27–34. doi:10.1212/WNL.0b013e3181e62124.Google Scholar
Feil, D., Razani, J., Boone, K. and Lesser, I. (2003). Apathy and cognitive performance in older adults with depression. International Journal of Geriatric Psychiatry, 18, 479–485. doi:10.1002/gps.869.CrossRefGoogle ScholarPubMed
Hegeman, J. M., Wardenaar, K. J., Comijs, H. C., de Waal, M. W., Kok, R. M. and van der Mast, R. C. (2012). The subscale structure of the Inventory of Depressive Symptomatology Self Report (IDS-SR) in older persons. Journal of Psychiatric Research, 46, 1383–1388. doi:10.1016/j.jpsychires.2012.07.008.Google Scholar
Hetrick, S. E., Parker, A. G., Hickie, I. B., Purcell, R., Yung, A. R. and McGorry, P. D. (2008). Early identification and intervention in depressive disorders: towards a clinical staging model. Psychotherapy and Psychosomatics, 77, 263–270. doi:10.1159/000140085.Google Scholar
Jolliffe, I. T. (1972). Discarding variables in a principal component analysis, I: Artificial data. Journal of the Royal Statistical Society, Series C (Applied Statistics), 21, 160–173. doi:10.2307/2346488.Google Scholar
Jorm, A. F. (2000). Is depression a risk factor for dementia or cognitive decline? A review. Gerontology, 46, 219–227. doi:10.1159/000022163.Google Scholar
Klein, M., Ponds, R. W., Houx, P. J. and Jolles, J. (1997). Effect of test duration on age-related differences in Stroop interference. Journal of clinical and experimental neuropsychology, 19, 77–82. doi:10.1080/01688639708403838.Google Scholar
Kriegsman, D. M., Penninx, B. W., van Eijk, J. T., Boeke, A. J. and Deeg, D. J. (1996). Self-reports and general practitioner information on the presence of chronic diseases in community dwelling elderly. A study on the accuracy of patients’ self-reports and on determinants of inaccuracy. Journal of Clinical Epidemiology, 49, 1407–1417. doi:10.1016/S0895-4356(96)00274-0.Google Scholar
Lampe, I. K. and Heeren, T. J. (2004). Is apathy in late-life depressive illness related to age-at-onset, cognitive function or vascular risk? International psychogeriatrics, 16, 481–486. doi:10.1017/S1041610204000766.CrossRefGoogle ScholarPubMed
Landelijke Stuurgroep Multidisciplinaire Richtlijnontwikkeling in de GGZ (2008). Multidisciplinaire Richtlijn Depressie, Addendum Ouderen [Guidelines for Diagnostics, Treatment, and Counselling of a Depressive Disorder, Addendum Older Adults].Google Scholar
Paterniti, S., Verdier-Taillefer, M. H., Dufouil, C. and Alperovitch, A. (2002). Depressive symptoms and cognitive decline in elderly people. Longitudinal study. The British Journal of Psychiatry, 181, 406–410. doi:10.1192/bjp.181.5.406.Google Scholar
Peretti, S., Judge, R. and Hindmarch, I. (2000). Safety and tolerability considerations: tricyclic antidepressants vs. selective serotonin reuptake inhibitors. Acta Psychiatrica Scandinavica. Supplementum, 403, 17–25. doi:10.1111/j.1600-0447.2000.tb10944.x.Google Scholar
Pietrzak, R. H. et al. (2012). Mild worry symptoms predict decline in learning and memory in healthy older adults: a 2-year prospective cohort study. American Journal of Geriatric Psychiatry, 20, 266–275. doi:10.1097/JGP.0b013e3182107e24.Google Scholar
Pimontel, M. A., Culang-Reinlieb, M. E., Morimoto, S. S. and Sneed, J. R. (2012). Executive dysfunction and treatment response in late-life depression. International Journal of Geriatric Psychiatry, 27, 893–899. doi:10.1002/gps.2808.Google Scholar
Rapp, M. A., Dahlman, K., Sano, M., Grossman, H. T., Haroutunian, V. and Gorman, J. M. (2005). Neuropsychological differences between late-onset and recurrent geriatric major depression. The American Journal of Psychiatry, 162, 691–698. doi:10.1176/appi.ajp.162.4.691 CrossRefGoogle ScholarPubMed
Rey, A. (1964). L'examen Clinique en Psychologie. Paris, France: Presses Universitaire de France.Google Scholar
Rush, A. J., Gullion, C. M., Basco, M. R., Jarrett, R. B. and Trivedi, M. H. (1996). The Inventory of Depressive Symptomatology (IDS): psychometric properties. Psychological Medicine, 26, 477–486. doi:10.1017/S0033291700035558.Google Scholar
Sheline, Y. I. et al. (2006). Cognitive function in late life depression: relationships to depression severity, cerebrovascular risk factors and processing speed. Biological Psychiatry, 60, 58–65. doi:10.1016/j.biopsych.2005.09.019.Google Scholar
Sonnenberg, C. M., Deeg, D. J. H., Comijs, H. C., van Tilburg, W. and Beekman, A. T. F. (2008). Trends in antidepressant use in the older population: results from the LASA-study over a period of 10 years. Journal of Affective Disorders, 111, 299–305. doi:10.1016/j.jad.2008.03.009.Google Scholar
Starkstein, S. E., Mayberg, H. S., Preziosi, T. J., Andrezejewski, P., Leiguarda, R. and Robinson, R. G. (1992). Reliability, validity, and clinical correlates of apathy in Parkinson's disease. The Journal of Neuropsychiatry and Clinical Neurosciences, 4, 134–139.Google ScholarPubMed
Stroop, J. R. (1935). Studies of interference in serial verbal reactions. Journal of Experimental Psychology: General, 18, 643–662. doi:10.1037/h0054651.Google Scholar
Tannenbaum, C., Paquette, A. l., Hilmer, S., Holroyd-Leduc, J. and Carnahan, R. (2012). A systematic review of amnestic and non-amnestic mild cognitive impairment induced by anticholinergic, antihistamine, GABAergic and opioid drugs. Drugs & Aging, 29, 639–658. doi:10.2165/11633250-000000000-00000.Google Scholar
Thomas, A. J. and O'Brien, J. T. (2008). Depression and cognition in older adults. Current Opinion in Psychiatry, 21, 8–13. doi:10.1097/YCO.0b013e3282f2139b.Google Scholar
van den Berg, J. F. et al. (2013). Correlates of alcohol abstinence and at-risk alcohol consumption in older adults with depression: the NESDO study. The American Journal of Geriatric Psychiatry, (in press). doi:10.1016/j.jagp.2013.04.006.Google Scholar
van Ojen, R., Hooijer, C., Bezemer, D., Jonker, C., Lindeboom, J. and van, T. W. (1995). Late-life depressive disorder in the community. I. The relationship between MMSE score and depression in subjects with and without psychiatric history. The British Journal of Psychiatry, 166, 311–315.CrossRefGoogle ScholarPubMed
Wechsler, D. (1958). The Measurement and Appraisal of Adult Intelligence, 4th edn. Baltimore, MD: Williams & Wilkins Co. doi:10.1037/11167-000.Google Scholar
Wisocki, P. A., Handen, B. and Morse, C. K. (1986). The worry scale as a measure of anxiety among homebound and community active elderly. The Behavior Therapist, 9, 91–95. doi:10.1016/0022-3956(94)90036-1.Google Scholar
Wittchen, H. U. (1994). Reliability and validity studies of the WHO–Composite International Diagnostic Interview (CIDI): a critical review. Journal of Psychiatric Research, 28, 57–84.Google Scholar
World Health Organization Collaborating Centre for Drug Statistics Methodology (2010). Anatomical Therapeutic Chemical (ATC) Classification. Available at: http://www.whocc.no/atc_ddd_index.Google Scholar