Executive dysfunction and the course of geriatric depression

Alexopoulos, George S.; Kiosses, Dimitris N.; Heo, Moonseong; Murphy, Christopher F.; Shanmugham, Bindu; Gunning-Dixon, Faith

doi:10.1016/j.biopsych.2005.04.024

Cited by 317Treatment of Major DepressionNeural and Behavioral Psychology StudiesAnxiety, Depression, Psychometrics, Treatment, Cognitive Processes

Executive dysfunction and the course of geriatric depression

Alexopoulos, George S., Kiosses, Dimitris N., Heo, Moonseong, Murphy, Christopher F., Shanmugham, Bindu, Gunning-Dixon, Faith·2005·Biological Psychiatry

DOI 10.1016/j.biopsych.2005.04.024

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Abstract

Background Executive dysfunction is common in geriatric depression and persists after improvement of depressive symptoms. This study examined the relationship of executive impairment to the course of depressive symptoms among elderly patients with major depression.Methods A total of 112 nondemented elderly patients with major depression participated in an 8-week citalopram trial at a target daily dose of 40 mg. Executive functions were assessed with the initiation/perseveration subscale of the Dementia Rating Scale and the Stroop Color-Word test. Medical burden was rated with the Cumulative Illness Rating Scale.Results Both abnormal initiation/perseveration and abnormal Stroop Color-Word scores were associated with an unfavorable response of geriatric depression to citalopram. In particular, initiation/perseveration scores below the median (< or =35) and Stroop scores at the lowest quartile (< or =22) predicted limited change in depressive symptoms. Impairment in other Dementia Rating Scale cognitive domains did not significantly influence the outcome of depression.Conclusions Executive dysfunction increases the risk for poor response of geriatric depression to citalopram. Because executive functions require frontostriatal-limbic integrity, this observation provides the rationale for investigation of the role of specific frontostriatal-limbic pathways in perpetuating geriatric depression. Depressed elderly patients with executive dysfunction require vigilant clinical attention because they might be at risk to fail treatment with a selective serotonin reuptake inhibiting antidepressant.

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Authors: Alexopoulos, G. S., Kiosses, D. N., Heo, M., Murphy, C. F., Shanmugham, B., & Gunning-Dixon, F.
Affiliations: Cornell University (US)
Corresponding author: Alexopoulos, George S.
ORCID: Alexopoulos, George S.
Kiosses, Dimitris N.
Heo, Moonseong
Murphy, Christopher F.
Venue: Biological Psychiatry
Publisher: Elsevier BV
Published: 2005-08
Volume: 58
Issue: 3
Pages: 204-210
ISSN: 0006-3223 (ISSN-L)
DOI: 10.1016/j.biopsych.2005.04.024
OpenAlex: W2030120831
Cited by: 317
References: 57
Citations by year: 2026: 9 · 2025: 9 · 2024: 4 · 2023: 4 · 2022: 10 · 2021: 12 · 2020: 15 · 2019: 10 · 2018: 21 · 2017: 18 · 2016: 13 · 2015: 21 · 2014: 15 · 2013: 24 · 2012: 25
FWCI: 9.20
Type: journal article
Language: en
Open access: closed
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations: Biological Psychiatry (publishedVersion)
PubMed (publishedVersion)
Funders: National Institute of Mental Health (P30MH068638, R01-MH51842, R01MH042819, R01MH065653)
Topics: Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
Life Sciences › Neuroscience › Cognitive Neuroscience › Neural and Behavioral Psychology Studies
Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
Keywords: executive dysfunction, geriatric depression, citalopram, treatment response prediction, Stroop task, Mattis Dementia Rating Scale, medical burden, selective serotonin reuptake inhibitors, cognitive impairment
MeSH terms: Aged, Aged, 80 and over, Antidepressive Agents, Demography, Depression, Female, Humans, Learning Disabilities, Male, Neuropsychological Tests, Predictive Value of Tests, Problem Solving, Psychiatric Status Rating Scales, Time Factors, Citalopram, Geriatric Assessment, Multivariate Analysis

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