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Greater Depression Severity Associated With Less Improvement in Depression-Associated Cognitive Deficits in Older Subjects

Received October 9, 2001; revised January 31, March 5, 2002; accepted March 11, 2002. From the Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina. Address correspondence to Dr. Taylor, Duke University Medical Center, DUMC 3903, Durham, NC 27710. e-mail: taylo066{at}mc.duke.edu

OBJECTIVES: Elderly depressed patients often exhibit cognitive deficits, which may improve with drug therapy. The authors investigated the relationship of baseline depression severity and cognitive improvement with antidepressant treatment in depressed patients with mild cognitive impairment. METHODS: Mini-Mental State Exam (MMSE) and Montgomery-Asberg Depression Rating Scale (MADRS) scores were measured in 52 depressed geriatric patients without dementia at baseline, 6, and 12 months, during an intent-to-treat period. A repeated-measures regression model tested the effect of MADRS score on MMSE. RESULTS: MMSE changes were significant and linear over time, with an average increase of 0.72 in the MMSE per 6-month interval. The final model showed that for every point increase in baseline MADRS, the average 6-month increase in MMSE decreased by 0.12. Repeated MADRS measurements did not significantly alter its predictive value. CONCLUSION: Greater baseline depression severity in older subjects with mild cognitive deficits is associated with less improvement in those deficits even with successful antidepressant therapy.

Key Words: Depression • Symptoms/Dimensions • Cognitive Functioning

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