Cognitive response to pharmacological treatment for depression in Alzheimer disease: secondary outcomes from the depression in Alzheimer's disease study (DIADS).
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.
Munro
Cynthia A
CA
Division of Medical Psychology, Department of Psychiatry and Behavioral Sciences, School of Medicine, The Johns Hopkins University, Baltimore, MD, USA. cmunro@jhmi.edu
Brandt
Jason
J
Sheppard
Jeannie-Marie E
JM
Steele
Cynthia D
CD
Samus
Quincy M
QM
Steinberg
Martin
M
Rabins
Peter V
PV
Lyketsos
Constantine G
CG
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
D017367:Selective Serotonin Reuptake Inhibitors; D020280:Sertraline