Effects of pharmacological therapy on gait and cognitive function in depressed patients

Clin Neuropharmacol. Mar-Apr 2007;30(2):63-71. doi: 10.1097/01.wnf.0000240949.41691.95.

Abstract

Objective: To investigate the relationship among affective status, cognitive function, and gait in depressed patients and to evaluate the effects of treatment of depression on gait and cognitive function.

Methods: Nineteen patients recently diagnosed with clinical depression (Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria) were recruited from a psychiatric outpatient clinic. Evaluation included the Hamilton Depression Rating Scale (HAM-D), the Mini-Mental State Examination, a computerized neuropsychological battery (Mindstreams, NeuroTrax Corp, New York, NY), and Barthel's Index of Instrumental Activities of Daily Living. Temporal parameters of gait were quantified using a stopwatch and force-sensitive insoles. All assessments were performed at baseline and after approximately 10 weeks of treatment with antidepressants.

Results: The patients' mean age was 68.6 +/- 9.1 years (15 women). Therapy significantly (P < 0.001) improved the affective state (HAM-D scores). There were small but significant improvements in gait speed (P = 0.033), stride time variability (P = 0.036), and gait asymmetry (P = 0.038). With the exception of the hand-eye coordination index, all tested cognitive domains also improved significantly. Baseline depression scores correlated with changes in depression: patients with higher HAM-D scores at baseline had more significant improvement in their affect (P < 0.001). Changes in HAM-D were not significantly correlated with changes in gait or changes on computerized tests of cognitive function (P > 0.10).

Conclusions: Depressive symptoms are associated with gait and cognitive impairment. Moreover, the present results suggest that these domains improve in response to antidepressant medication.

Publication types

  • Evaluation Study
  • Research Support, N.I.H., Extramural

MeSH terms

  • Activities of Daily Living
  • Aged
  • Antidepressive Agents / pharmacology*
  • Antidepressive Agents / therapeutic use
  • Cognition / drug effects*
  • Depression / drug therapy
  • Depression / physiopathology*
  • Depression / psychology*
  • Female
  • Gait / drug effects*
  • Humans
  • Male
  • Mental Status Schedule
  • Middle Aged
  • Neuropsychological Tests
  • Prospective Studies
  • Statistics, Nonparametric
  • Treatment Outcome

Substances

  • Antidepressive Agents