Cognitive Improvement Following Treatment in Late-Life Depression: Relationship to Vascular Risk and Age of Onset
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Objectives To test the hypothesis that the degree of vascular burden and/or age of onset may influence the degree to which cognition can improve during the course of treatment in late-life depression.Design Measurement of cognition both before and following 12 weeks of treatment with sertraline.Setting University medical centers (Washington University and Duke University).Participants One hundred sixty-six individuals with late-life depression.Intervention Sertraline treatment.Measurements The cognitive tasks were grouped into five domains (language, processing speed, working memory, episodic memory, and executive function). We measured vascular risk using the Framingham Stroke Risk Profile measure. We measured T2-based white matter hyperintensities using the Fazekas criteria.Results Both episodic memory and executive function demonstrated significant improvement among adults with late-life depression during treatment with sertraline. Importantly, older age, higher vascular risk scores, and lower baseline Mini-Mental State Examination scores predicted less change in working memory. Furthermore, older age, later age of onset, and higher vascular risk scores predicted less change in executive function.Conclusions These results have important clinical implications in that they suggest that a regular assessment of vascular risk in older adults with depression is necessary as a component of treatment planning and in predicting prognosis, both for the course of the depression itself and for the cognitive impairments that often accompany depression in later life.
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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 [91]
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Buccianelli, B., Marazziti, D., Arone, A., Palermo, S., Simoncini, M., Carbone, M. G., Massoni, L., Violi, M., & Dell’Osso, L. (2023) · Brain Sciences · doi:10.3390/brainsci13081200 · Cited by 3 · see citing works
Moving Beyond Mood: Is it Time to Recommend Cognitive Training for Depression in Older Adults?
Naismith, S. L., & Mowszowski, L. (2016) · Springer eBooks · doi:10.1007/978-3-319-32480-7_21 · Cited by 2 · see citing works
Models of depressive pseudoamnestic disorder
Choi, J.-W., Lee, S., Motter, J. N., Kim, H., Andrews, H., Doraiswamy, P. M., Devanand, D. P., & Goldberg, T. E. (2022) · Alzheimer s & Dementia Translational Research & Clinical Interventions · doi:10.1002/trc2.12335 · Cited by 2 · see citing works
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Cognitive Dimensions of Depression: Assessment, Neurobiology, and Treatment
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- Authors
- Barch, D. M., D'Angelo, G., Pieper, C., Wilkins, C. H., Welsh-Bohmer, K., Taylor, W., Garcia, K. S., Gersing, K., Doraiswamy, P. M., & Sheline, Y. I.
- Affiliations
- Washington University in St. Louis (US)
- Duke University (US)
- Corresponding author
- Barch, Deanna M.
- ORCID
- Venue
- The American Journal of Geriatric Psychiatry
- Publisher
- Elsevier BV
- Published
- 2012-08
- Volume
- 20
- Issue
- 8
- Pages
- 682-690
- ISSN
- 1064-7481 (ISSN-L)
- PMC
- PMC3382028
- OpenAlex
- W2106744889
- Cited by
- 64
- References
- 40
- Citations by year
- 2026: 1 · 2025: 3 · 2024: 5 · 2023: 1 · 2022: 4 · 2021: 6 · 2020: 4 · 2019: 3 · 2018: 5 · 2017: 7 · 2016: 4 · 2015: 5 · 2014: 7 · 2013: 7 · 2012: 2
- FWCI
- 4.72
- Type
- journal article
- Language
- en
- Open access
- green
- europepmc.org
- Locations
- American Journal of Geriatric Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- U.S. Public Health Service (K24 65421)
- National Institute on Aging (K25AG035062)
- National Institute of Mental Health (R01MH060697, R01MH062158)
- National Center for Research Resources (RR.00036, M01RR000036)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Keywords
- geriatric depression, cognitive enhancement, sertraline, vascular risk, age of onset, white matter hyperintensities, episodic memory, executive function, working memory, processing speed, language, older adults, antidepressant response
- MeSH terms
- Aged, Antidepressive Agents, Cognition Disorders, Depression, Female, Humans, Male, Memory, Mental Status Schedule, Severity of Illness Index, Vascular Diseases, Treatment Outcome, Age of Onset, Sertraline, Executive Function
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