Cognitive outcomes after psychotherapeutic interventions for major depression in older adults with executive dysfunction

Am J Geriatr Psychiatry. 2014 Dec;22(12):1496-503. doi: 10.1016/j.jagp.2013.11.002. Epub 2013 Nov 16.


Objective: The purpose of this study was to determine the impact of psychotherapy on cognitive functioning in older adults with late-life depression (LLD) and executive dysfunction.

Methods: Two hundred twenty-one adults aged 60 years and older participated in a randomized clinical trial comparing the efficacy of Problem Solving Therapy (PST) and Supportive Therapy (ST) for LLD. Cognitive performance on seven tests of executive functioning, verbal learning, and memory was evaluated at baseline, after 12 weeks of treatment, and at 24 weeks after the completion of treatment.

Results: Performance on a measure of executive functioning with a significant information processing speed component (Stroop Color and Word Test) improved after treatment, F (1, 312) = 8.50, p = 0.002, and improved performance was associated with a reduction in depressive symptoms but not treatment type. Performance on other measures of executive functioning, verbal learning, and memory did not change significantly after 12 weeks of psychotherapy treatment.

Conclusion: Our results suggest that improvements in cognitive functioning after psychotherapy treatment for depression in older adults with executive dysfunction are likely focal and not distributed across all cognitive domains. Although previous analyses reported that PST was superior to ST in the treatment of depression, this analysis indicated no difference between the two treatments with regard to improvements in cognitive functioning.

Keywords: Cognitive functioning; executive dysfunction; information processing speed; late-life depression; learning; memory; mild cognitive impairment; psychotherapy.

Publication types

  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Cognition Disorders / diagnosis
  • Cognition Disorders / epidemiology
  • Cognition Disorders / therapy*
  • Comorbidity
  • Depressive Disorder, Major / epidemiology
  • Depressive Disorder, Major / therapy*
  • Executive Function / physiology*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Psychotherapy / methods*
  • Severity of Illness Index
  • Treatment Outcome