Performance feedback deficit in geriatric depression

Background: The orbital frontal cortex is involved with processing of perfo rmance feedback. This study tests the hypothesis that older depressed subje cts, compared with elderly control subjects, commit more subsequent errors after receiving feedback from an initial error. Methods: We administered 116 older depressed patients and 139 control subje cts the Trail Making Test Part B (TRAILS-B). Subjects who committed an erro r on TRAILS-B were immediately given feedback on performance. We then measu red the frequency of making an error on the subsequent three tries. The lik elihood of making any subsequent error was examined. Results: After controlling for the overall initial error rate, more depress ed patients than control subjects made subsequent errors. This association remained significant in later regression models. When the depressed group w as examined in additional models, severity of depression was not associated with increased subsequent errors. Conclusions: These results extend previous findings suggesting a performanc e feedback deficit in geriatric depression. The findings support previous s tudies linking the orbital frontal cortex and depression. Biol Psychiatry 2 001;50: 358-363 (C) 2001 Society of Biological Psychiatry.