title: Cognitive response to pharmacological treatment for depression in Alzheimer disease: secondary outcomes from the depression in Alzheimer's disease study (DIADS).
abstract: OBJECTIVE
  The authors assessed the cognitive effects of depression treatment with sertraline in patients with Alzheimer disease (AD) and major depression.
  
  
  METHODS
  Forty-four patients with probable AD and major depression were enrolled in a double-blind, placebo-controlled clinical trial of sertraline. Cognitive testing was done at baseline and at 3-week intervals throughout the 12-week study. At the 12th week, subjects were categorized by treatment response (full, partial, or no response). Cognitive data from 41 participants who completed three or more testing sessions and 36 who completed all five study visits were included in the analyses.
  
  
  RESULTS
  Neither improved mood nor use of sertraline was associated with cognitive change over time in AD patients. Post-hoc exploration of the data, however, suggested a sex difference in cognitive response to sertraline such that women treated with sertraline demonstrated improved cognition compared with women on placebo, whereas men treated with sertraline worsened significantly in cognition compared with men on placebo.
  
  
  CONCLUSIONS
  In this study, among depressed AD patients after treatment with sertraline or placebo, there was no evidence that improved mood was associated with cognitive improvement. Future studies aimed at increasing power to detect mood as well as medication effects will be valuable in determining the relationship between cognition and treatment of depression in AD patients.
authors.affiliation: Division of Medical Psychology, Department of Psychiatry and Behavioral Sciences, School of Medicine, The Johns Hopkins University, Baltimore, MD, USA. cmunro@jhmi.edu
authors.forename: Cynthia A
authors.initials: CA
authors.lastname: Munro
authors.forename: Jason
authors.initials: J
authors.lastname: Brandt
authors.forename: Jeannie-Marie E
authors.initials: JM
authors.lastname: Sheppard
authors.forename: Cynthia D
authors.initials: CD
authors.lastname: Steele
authors.forename: Quincy M
authors.initials: QM
authors.lastname: Samus
authors.forename: Martin
authors.initials: M
authors.lastname: Steinberg
authors.forename: Peter V
authors.initials: PV
authors.lastname: Rabins
authors.forename: Constantine G
authors.initials: CG
authors.lastname: Lyketsos
mesh_terms: D000368:Aged; D000544:Alzheimer Disease / Q000523:psychology* / Q000628:therapy*; D003072:Cognition Disorders / Q000175:diagnosis*; D003865:Major Depressive Disorder / Q000188:drug therapy* / Q000209:etiology*; D004311:Double-Blind Method; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D009483:Neuropsychological Tests; D011594:Psychometrics; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use*; D020280:Sertraline / Q000627:therapeutic use*; D012720:Severity of Illness Index
chemical_list: D017367:Selective Serotonin Reuptake Inhibitors; D020280:Sertraline