The role of depression severity in the cognitive functioning of elderly subjects with central nervous system disease.
OBJECTIVE
To examine the hypothesis that there is a causal relation between depression and cognitive dysfunction in patients with central nervous system (CNS) disease.


METHODS
Retrospective analysis of a clinical database.


METHODS
Tertiary geriatric day hospital.


METHODS
Sixty-five patients with depression and CNS disease, and 201 patients with depression but without CNS disease.


METHODS
Scores on the Hamilton Depression Rating Scale (Ham-D) and the Mattis Dementia Rating Scale (MDRS).


RESULTS
A logistic regression analysis using MDRS status as the dependent variable, and a number of clinical variables as the predictor variables, showed that, in patients with CNS disease, only the Ham-D score predicted MDRS status (R = -0.19, p = 0.02). Ham-D score even more strongly predicted scores on a frontal system subtest of the MDRS (R = -0.262, p = 0.005). Ham-D score did not predict MDRS status in patients without CNS disease. Mean Mini Mental State Examination scores for the group with CNS disease were 25.1 at admission and 26.1 at discharge (p < 0.001).


CONCLUSIONS
These findings suggest that depression contributes to frontal cognitive dysfunction in patients with CNS disease.
van Reekum
R
R
Department of Psychiatry, University of Toronto, Ont.
Simard
M
M
Clarke
D
D
Conn
D
D
Cohen
T
T
Wong
J
J
D000368:Aged; D001927:Brain Diseases / Q000150:complications; D003072:Cognition Disorders / Q000150:complications* / Q000175:diagnosis*; D003863:Depression / Q000150:complications* / Q000175:diagnosis*; D005260:Female; D006801:Humans; D008297:Male; D009483:Neuropsychological Tests; D011237:Predictive Value of Tests; D012720:Severity of Illness Index