Diagnosis and treatment of depression and cognitive impairment in late life

Ann N Y Acad Sci. 2015 May;1345(1):36-46. doi: 10.1111/nyas.12669. Epub 2015 Feb 5.

Abstract

Cognitive impairment in late-life depression is prevalent, disabling, and heterogeneous. Although mild cognitive impairment in depression does not usually progress to dementia, accurate assessment of cognition is vital to prognosis and treatment planning. For example, executive dysfunction often accompanies late-life depression, influences performance across cognitive domains, and is associated with poor antidepressant treatment outcomes. Here, we review how assessment can capture dysfunction across cognitive domains and discuss cognitive trajectories frequently observed in late-life depression in the context of the neurobiology of this disorder. We also review the efficacy of a sample of interventions tailored to specific cognitive profiles.

Keywords: antidepressants; cognitive control; cognitive impairment; geriatric depression; older adults; psychotherapy.

Publication types

  • Review

MeSH terms

  • Aged
  • Aged, 80 and over
  • Alzheimer Disease / complications
  • Alzheimer Disease / psychology
  • Alzheimer Disease / therapy
  • Antidepressive Agents / therapeutic use
  • Cognition Disorders / diagnosis*
  • Cognition Disorders / psychology
  • Cognition Disorders / therapy*
  • Cognitive Dysfunction / diagnosis
  • Cognitive Dysfunction / psychology
  • Cognitive Dysfunction / therapy
  • Dementia / diagnosis
  • Dementia / psychology
  • Dementia / therapy
  • Depressive Disorder, Major / diagnosis*
  • Depressive Disorder, Major / psychology
  • Depressive Disorder, Major / therapy*
  • Geriatric Assessment / methods
  • Humans
  • Psychotherapy / methods

Substances

  • Antidepressive Agents