Cognitive Impairment in Depressed Older Adults: Implications for Prognosis and Treatment
Open accessAbstract
Late-life depression is often accompanied by cognitive impairment. In some cases, the syndromes of depression and cognitive impairment may be related to the same underlying disorder (eg, vascular dementia, hypothyroidism), whereas in other cases, they may be relatively independent and simply coexist. Cognitive deficits in late-life depression span multiple domains; however, deficits in executive functions may be particularly important as their presence predicts poor clinical outcomes. Cognitive impairment, when mild, does not appear to progress to dementia in most cases, but variability in the course of elders with depression and cognitive impairment suggests the need for careful follow-up, particularly in cases where executive dysfunction is suspected. The Expert Consensus Guideline recommends antidepressant drug therapy combined with a psychosocial intervention as the treatment of choice for geriatric depression. New treatments including computerized cognitive remediation and problem-solving therapy may be particularly effective in treating both affective and cognitive symptoms.
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Standard antidepressants often fail in older patients who have executive dysfunction or high neuroticism.
“Older adults with executive dysfunction and neuroticism are commonly treatment-resistant to standard antidepressants13, 14.”
From State of the Science of Neural Systems in Late‐Life Depression: Impact on Clinical Presentation and Treatment Outcome (2018) · cites this paper as [13]
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- Authors
- Morimoto, S. S., Kanellopoulos, T., & Alexopoulos, G. S.
- Affiliations
- Cornell University (US)
- Weill Cornell Medicine (US)
- Venue
- Psychiatric Annals
- Publisher
- SLACK, Inc.
- Published
- 2014-03
- Volume
- 44
- Issue
- 3
- Pages
- 138-142
- ISSN
- 0048-5713 (ISSN-L)
- 1938-2456
- PMC
- PMC4376269
- OpenAlex
- W2313728042
- Cited by
- 66
- References
- 29
- Citations by year
- 2026: 5 · 2025: 9 · 2024: 11 · 2023: 7 · 2022: 11 · 2021: 6 · 2020: 7 · 2019: 4 · 2018: 4 · 2017: 2
- FWCI
- 0.51
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Psychiatric Annals (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute on Aging (L30 AG040834)
- National Institute of Mental Health (P30MH085943, K23MH095830, L30 MH104906, T32MH019132)
- 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 impairment, executive dysfunction, prognosis, dementia progression, vascular dementia, hypothyroidism, antidepressant treatment, psychosocial interventions, problem-solving therapy
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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