title: Executive function and short-term remission of geriatric depression: the role of semantic strategy.
abstract: BACKGROUND
  This study tested the hypothesis that use of semantic organizational strategy in approaching the Mattis Dementia Rating Scale (MDRS) complex verbal initiation/perseveration (CV I/P) task, a test of semantic fluency, is the function specifically associated with remission of late-life depression.
  
  
  METHODS
  Seventy elders with major depression participated in a 12-week escitalopram treatment trial. Neuropsychologic performance was assessed at baseline after a 2-week drug washout period. Patients with a Hamilton Depression Rating Scale Score ≤7 for 2 consecutive weeks and who no longer met Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, criteria were considered to be remitted. Cox's proportional hazards survival analysis was used to examine the relationship between subtests of the I/P, other neuropsychologic domains, and remission rate. Participants' performance on the CV I/P subscale was coded for perseverations, and use of semantic strategy.
  
  
  RESULTS
  The relationship between the performance on the CV I/P subscale and remission rate was significant. No other subtest of the MDRS I/P evidenced this association. There was no significant relationship between speed, confrontation naming, verbal memory, or perseveration with remission rate. Remitters' use of verbal strategy was significantly greater than nonremitters.
  
  
  CONCLUSIONS
  Geriatric depressed patients who showed decrements in performance on a semantic fluency task showed poorer remission rates than those who showed adequate performance on this measure. Executive impairment in verbal strategy explained performance. This finding supports the concept that executive functioning exerts a "top down" effect on other basic cognitive processes, perhaps as a result of frontostriatal network dysfunction implicated in geriatric depression.
authors.affiliation: Weill Cornell Medical College, Department of Psychiatry, Institute of Geriatric Psychiatry, White Plains, NY 10605, USA.
authors.forename: Sarah Shizuko
authors.initials: SS
authors.lastname: Morimoto
authors.forename: Faith M
authors.initials: FM
authors.lastname: Gunning
authors.forename: Christopher F
authors.initials: CF
authors.lastname: Murphy
authors.forename: Dora
authors.initials: D
authors.lastname: Kanellopoulos
authors.forename: Robert E
authors.initials: RE
authors.lastname: Kelly
authors.forename: George S
authors.initials: GS
authors.lastname: Alexopoulos
mesh_terms: D000368:Aged; D018687:Antidepressive Agents, Second-Generation / Q000627:therapeutic use; D015283:Citalopram / Q000627:therapeutic use; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000188:drug therapy / Q000523:psychology*; D056344:Executive Function; D006801:Humans; D009483:Neuropsychological Tests; D011569:Psychiatric Status Rating Scales; D012074:Remission Induction
chemical_list: D018687:Antidepressive Agents, Second-Generation; D015283:Citalopram
references.citation: Arch Clin Neuropsychol. 2004 Aug;19(5):597-611
references.pmid: 15271406
references.citation: J Psychiatr Res. 1975 Nov;12(3):189-98
references.pmid: 1202204
references.citation: Am J Psychiatry. 2002 Nov;159(11):1929-32
references.pmid: 12411231
references.citation: Biol Psychiatry. 2005 Aug 1;58(3):204-10
references.pmid: 16018984
references.citation: Arch Gen Psychiatry. 1999 Aug;56(8):713-8
references.pmid: 10435605
references.citation: Psychol Med. 1998 Sep;28(5):1015-26
references.pmid: 9794009
references.citation: Arch Clin Neuropsychol. 2007 Feb;22(2):261-70
references.pmid: 17443924
references.citation: Am J Geriatr Psychiatry. 2007 Jul;15(7):553-63
references.pmid: 17586780
references.citation: Am J Geriatr Psychiatry. 2008 Sep;16(9):752-9
references.pmid: 18697883
references.citation: Neuropsychopharmacology. 2004 Dec;29(12):2266-71
references.pmid: 15340392
references.citation: J Affect Disord. 2008 Nov;111(1):46-51
references.pmid: 18304646
references.citation: Acta Psychiatr Scand Suppl. 2002;(415):7-11
references.pmid: 12492767
references.citation: Cereb Cortex. 2005 Sep;15(9):1438-50
references.pmid: 15647526
references.citation: Am J Geriatr Psychiatry. 2004 Jul-Aug;12(4):387-94
references.pmid: 15249276
references.citation: Int J Geriatr Psychiatry. 2009 May;24(5):459-68
references.pmid: 18819162
references.citation: Arch Gen Psychiatry. 2000 Mar;57(3):285-90
references.pmid: 10711915
references.citation: Biol Psychiatry. 2007 Apr 15;61(8):1007-10
references.pmid: 17123478
references.citation: Neuropsychopharmacology. 2004 Dec;29(12):2278-84
references.pmid: 15340393
references.citation: Am J Psychiatry. 2008 Feb;165(2):238-44
references.pmid: 18172016
references.citation: Cereb Cortex. 2009 Dec;19(12):2767-96
references.pmid: 19329570
references.citation: J Neurosci. 2006 Jun 14;26(24):6523-32
references.pmid: 16775140
references.citation: Arch Gen Psychiatry. 1988 Aug;45(8):742-7
references.pmid: 3395203
references.citation: Psychol Aging. 2004 Sep;19(3):482-94
references.pmid: 15382998
references.citation: Acta Psychiatr Scand Suppl. 1987;334:1-100
references.pmid: 2887090
references.citation: Am J Geriatr Psychiatry. 2009 Jan;17(1):30-42
references.pmid: 19001356
references.citation: Am J Geriatr Psychiatry. 2002 Jan-Feb;10(1):98-106
references.pmid: 11790640
references.citation: Neuropsychopharmacology. 2007 Oct;32(10):2135-42
references.pmid: 17299509