Executive Functioning Complaints and Escitalopram Treatment Response in Late-Life Depression
Open accessAbstract
Objective Executive dysfunction may play a key role in the pathophysiology of late-life depression. Executive dysfunction can be assessed with cognitive tests and subjective report of difficulties with executive skills. The present study investigated the association between subjective report of executive functioning complaints and time to escitalopram treatment response in older adults with major depressive disorder (MDD).Methods 100 older adults with MDD (58 with executive functioning complaints and 42 without executive functioning complaints) completed a 12-week trial of escitalopram. Treatment response over 12 weeks, as measured by repeated Hamilton Depression Rating Scale scores, was compared for adults with and without executive complaints using mixed-effects modeling.Results Mixed effects analysis revealed a significant group × time interaction, F(1, 523.34) = 6.00, p = 0.01. Depressed older adults who reported executive functioning complaints at baseline demonstrated a slower response to escitalopram treatment than those without executive functioning complaints.Conclusion Self-report of executive functioning difficulties may be a useful prognostic indicator for subsequent speed of response to antidepressant medication.
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Executive dysfunction predicts poor response of LLD to antidepressants and early relapse and recurrence.
“Executive dysfunction predicts poor response of LLD to antidepressants and early relapse and recurrence32–38.”
From Mechanisms and treatment of late-life depression (2019) · cites this paper as [38]
DED is a syndrome with poor response to antidepressants.
“Problem solving therapy was more effective that supportive therapy in reducing depression and disability in older adults with DED162,163, a syndrome with poor response to antidepressants32–38,164.”
From Mechanisms and treatment of late-life depression (2019) · cites this paper as [38]
The depression-executive dysfunction (DED) syndrome has a slow or poor response to antidepressants.
“The depression-executive dysfunction (DED) syndrome has a slow or poor response to antidepressants32–38,164.”
From Mechanisms and treatment of late-life depression (2019) · cites this paper as [38]
In older adults with major depression, poorer objective response inhibition, sustained attention, and cognitive flexibility, and more subjective complaints in these areas, predict worse antidepressant response.
“worse performance on behavioral measures requiring response inhibition, sustained attention, and cognitive flexibility, as well as greater subjective complaints of perceived weaknesses in these domains, are predictive of poor antidepressant treatment response in older adults with major depression26–28.”
From State of the Science of Neural Systems in Late‐Life Depression: Impact on Clinical Presentation and Treatment Outcome (2018) · cites this paper as [27]
Impairments in cognitive control domains, including cognitive flexibility and executive function, have been repeatedly tied to behavioral treatment outcomes.
“Impairments in cognitive control domains, including cognitive flexibility and executive function, have been repeatedly tied to behavioral treatment outcomes (89–91).”
From The Role of Exercise in Management of Mental Health Disorders: An Integrative Review (2021) · cites this paper as [90]
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- Authors
- Manning, K. J., Alexopoulos, G. S., Banerjee, S., Morimoto, S. S., Seirup, J. K., Klimstra, S. A., Yuen, G., Kanellopoulos, T., & Gunning-Dixon, F.
- Affiliations
- Cornell University (US)
- Venue
- The American Journal of Geriatric Psychiatry
- Publisher
- Elsevier BV
- Published
- 2015-05
- Volume
- 23
- Issue
- 5
- Pages
- 440-445
- ISSN
- 1064-7481 (ISSN-L)
- PMC
- PMC4043930
- OpenAlex
- W2038726638
- Cited by
- 49
- References
- 15
- Citations by year
- 2026: 2 · 2025: 3 · 2024: 1 · 2023: 2 · 2022: 3 · 2021: 7 · 2020: 9 · 2019: 3 · 2018: 4 · 2017: 3 · 2016: 2 · 2015: 7 · 2014: 3
- FWCI
- 2.94
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- American Journal of Geriatric Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of Mental Health (P30 MH085943, R01 MH065653, R01 MH079414, T32 MH019132)
- Sanchez Foundation
- Topics
- Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Keywords
- executive dysfunction, escitalopram, geriatric depression, antidepressant response, treatment response time, prognostic factors, subjective cognitive complaints, Hamilton Depression Rating Scale
- MeSH terms
- Late Onset Disorders, Adult, Aged, Ambulatory Care Facilities, Major Depressive Disorder, Female, Humans, Male, Middle Aged, Prognosis, Psychiatric Status Rating Scales, Citalopram, Treatment Outcome, Drug Monitoring, Antidepressive Agents, Second-Generation, Diagnostic and Statistical Manual of Mental Disorders, Executive Function, Self Report
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