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Longitudinal Association of Initiation/Perseveration and Severity of Geriatric Depression

Received July 17, 2002; revised January 28, 2003; accepted February 6, 2003. From Weill Medical College of Cornell University, White Plains, NY. Address correspondence to Dr. George S. Alexopoulos, Professor of Psychiatry, Weill Medical College of Cornell University, 21 Bloomingdale Road, White Plains, NY 10605. e-mail: galexop{at}med.cornell.edu

Objective: Many older adults with major depression (MDD) present with impairment in initiation and perseveration (IP) tests. However, it remains unclear how these abnormalities change during the course of depression. Methods: The authors studied the longitudinal covariation of depression severity and IP functioning in 157 depressed older adults with MDD. Patients with and without baseline IP impairment were studied on three occasions over 1 year. Results: Depression severity was associated with concurrent IP scores; however, despite IP improvement, those with impaired baseline IP functioning did not reach the level of their non-impaired counterparts. Conclusion: The persistence of IP abnormalities suggests that these patients require careful treatment planning and follow-up, given that earlier studies noted an association of abnormal IP with disability and poor outcomes of depression treatment.

Key Words: Depression • Initiation/Perseveration

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