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Cited by 110Treatment of Major DepressionAnxiety, Depression, Psychometrics, Treatment, Cognitive ProcessesNeural and Behavioral Psychology Studies

A Meta-Analysis of Executive Dysfunction and Antidepressant Treatment Response in Late-Life Depression

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Pimontel, Monique A., Rindskopf, David, Rutherford, Bret R., Brown, Patrick J., Roose, Steven P., Sneed, Joel R.·2016·The American Journal of Geriatric Psychiatry
DOI 10.1016/j.jagp.2015.05.010PMC PMC4928373
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Abstract

Objective Depressed older adults with executive dysfunction (ED) may respond poorly to antidepressant treatment. ED is a multifaceted construct and different studies have measured different aspects of ED, making it unclear which aspects predict poor response. Meta-analytic methods were used to determine whether ED predicts poor antidepressant treatment response in late-life depression and to determine which domains of executive functioning are responsible for this relationship. Methods A Medline search was conducted to identify regimented treatment trials contrasting executive functioning between elderly responders and nonresponders; only regimented treatment trials for depressed outpatients aged 50 and older were included. Following the most recent PRISMA guidelines, 25 measures of executive functioning were extracted from eight studies. Six domains were identified: cognitive flexibility, planning and organization, response inhibition, selective attention, verbal fluency, and the Dementia Rating Scale Initiation/Perseveration composite score (DRS I/P). Hedge's g was calculated for each measure of executive functioning. A three-level Bayesian hierarchical linear model (HLM) was used to estimate effect sizes for each domain of executive functioning. Results The effect of planning and organization was significantly different from zero (Bayesian HLM estimate of domain effect size: 0.91; 95% CI: 0.32-1.58), whereas cognitive flexibility, response inhibition, selective attention, verbal fluency, and the DRS I/P composite score were not. Conclusion The domain of planning and organization is meaningfully associated with poor antidepressant treatment response in late-life depression. These findings suggest that therapies that focus on planning and organization may provide effective augmentation strategies for antidepressant nonresponders with late-life depression.

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  • Late-life depression (LLD) is characterized by impairments in various cognitive domains, particularly executive function deficits (EFD).

    “In contrast to MDD in young populations, LLD is characterized by impairments in various cognitive domains, particularly the executive function deficits (EFD).”

    From Can Intermittent Theta-Burst Stimulation of Dorsolateral Prefrontal Cortex Relieve Executive Dysfunction in Patients With Late-Life Depression? (2024) · cites this paper as [2]

    The Introduction (page unavailable) discusses executive-function deficits in late-life depression and identifies several executive-function domains. It does not establish impairments across other cognitive domains or compare late-life depression with MDD in younger populations. (LLM, conf=0.84)

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Authors
Pimontel, M. A., Rindskopf, D., Rutherford, B. R., Brown, P. J., Roose, S. P., & Sneed, J. R.
Affiliations
  • Queens College, CUNY (US)
  • The Graduate Center, CUNY (US)
  • New York State Psychiatric Institute (US)
Corresponding author
Sneed, Joel R.
ORCID
Venue
The American Journal of Geriatric Psychiatry
Publisher
Elsevier BV
Published
2016-01
Volume
24
Issue
1
Pages
31-41
ISSN
1064-7481 (ISSN-L)
DOI
10.1016/j.jagp.2015.05.010
PMC
PMC4928373
OpenAlex
W324962452
Cited by
110
References
14
Citations by year
2026: 10 · 2025: 12 · 2024: 9 · 2023: 11 · 2022: 6 · 2021: 21 · 2020: 15 · 2019: 2 · 2018: 11 · 2017: 7 · 2016: 5 · 2015: 1
FWCI
0.98
Type
journal article
Language
en
Open access
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • American Journal of Geriatric Psychiatry (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
Funders
National Institute of Mental Health (K23MH099097)
Topics
  • Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
  • Life Sciences › Neuroscience › Cognitive Neuroscience › Neural and Behavioral Psychology Studies
Keywords
executive dysfunction, geriatric depression, antidepressant response, treatment non-response, planning and organization, cognitive flexibility, response inhibition, selective attention, verbal fluency, Mattis Dementia Rating Scale, older adults
MeSH terms
Aged, Antidepressive Agents, Bayes Theorem, Clinical Trials as Topic, Cognition Disorders, Depression, Major Depressive Disorder, Humans, Treatment Outcome, Executive Function

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