Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Email this article to a Colleague Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to My Articles & Searches Download to citation manager Citing Articles via HighWire Citing Articles via Google Scholar Articles by Cui, X. Articles by Caine, E. D. Search for Related Content PubMed Citation Articles by Cui, X. Articles by Caine, E. D. Geriatric Psychiatry Depression Dementias (General)

Does Depression Precede or Follow Executive Dysfunction? Outcomes in Older Primary Care Patients

OBJECTIVE: The authors sought to test the potentially reciprocal relationships between depression and executive dysfunction in older patients over time. METHOD: In this prospective 2-year cohort study, the authors enrolled 709 patients age 65 years and older who presented for primary care on selected days and gave informed consent. Of these, 431 and 284 patients completed follow-up interviews at 1 year and 2 years, respectively. The main outcome measures included depression diagnosis, and measures assessing selected components of executive functions: the initiation-perseveration subscale of the Mattis Dementia Rating Scale, Trail Making tests A and B, and D Trails (Trails B time minus Trails A time). RESULTS: No cognitive measure was significantly independently associated with depression diagnosis concurrently or in 1-year lagged outcomes. A diagnosis of depression was independently associated with concurrent poorer Trails B time and with both Trails B and D Trails times in 1-year lagged models. In path analyses testing 2-year competing dynamic models, no baseline executive function measure predicted the score on the Hamilton Depression Rating Scale (HAM-D), but HAM-D score independently predicted poorer Trails B and D Trails times. Overall medical burden also independently predicted both depressive and cognitive outcomes, but cerebrovascular risk factors only predicted Trails B time. CONCLUSIONS: Older persons with depression are at risk of subsequent decline in at least some aspects of executive functioning. The study’s findings leave open the possibility that either neurobiological or psychosocial factors play prominent roles in the mechanisms underlying the course of geriatric depression.

This article has been cited by other articles:

				J. M. Lyness Depression and Comorbidity: Objects in the Mirror are More Complex Than They Appear Am J Geriatr Psychiatry, March 1, 2008; 16(3): 181 - 185. [Full Text] [PDF]

				D. VINKERS and R. van der MAST Depression and Executive Dysfunction in Old Age Am J Psychiatry, January 1, 2008; 165(1): 136 - 136. [Full Text] [PDF]

Get information about faster international access.

Privacy Policy

Copyright © 2007 American Psychiatric Association. All rights reserved.

Home | Search | Current Issue | Past Issues | Subscribe | All APPI Journals | Help | Contact Us