Changes in cognitive functioning following treatment of late-life depression

Objective: Knowledge of the relationship between various clinical character istics and cognitive functioning is advancing, but little is known about th e cognitive response to treatment for geriatric depression. The purpose of this study was to examine the cognitive response to treatment for patients with late-life depression. Method: Subjects included 45 nondemented, elderly depressed patients who ac hieved remission after 12 weeks of antidepressant treatment and 20 elderly comparison subjects. All subjects were administered a battery of clinical m easures, including cognitive screening instruments, before and after treatm ent. Results: As a group, the elderly depressed patients showed a small improvem ent in overall cognitive functioning after treatment. Among depressed patie nts with concomitant cognitive impairment at baseline, performance on the M attis Dementia Rating Scale domains of conceptualization and initiation/per severation improved significantly relative to those of depressed patients w ith normal cognition. Despite the improvement following treatment, the over all level of cognitive functioning in the elderly depressed patients with c ognitive impairment at baseline remained mildly impaired, especially in the memory and initiation/perseveration domains. Conclusions: Elderly depressed patients with cognitive impairment may exper ience improvement in specific domains following antidepressant treatment bu t may not necessarily reach normal levels of performance, particularly in m emory and executive functions. This subgroup of late-life depression patien ts is likely at high risk of developing progressive dementia.