title: Cognitive improvement following treatment in late-life depression:  relationship to vascular risk and age of onset.
abstract: OBJECTIVE
  To test the hypothesis that the degree of vascular burden and/or age of onset may influence the degree to which cognition can improve during the course of treatment in late-life depression.
  
  
  METHODS
  Measurement of cognition both before and following 12 weeks of treatment with sertraline.
  
  
  METHODS
  University medical centers (Washington University and Duke University).
  
  
  METHODS
  One hundred sixty-six individuals with late-life depression.
  
  
  METHODS
  Sertraline treatment.
  
  
  METHODS
  The cognitive tasks were grouped into five domains (language, processing speed, working memory, episodic memory, and executive function). We measured vascular risk using the Framingham Stroke Risk Profile measure. We measured T2-based white matter hyperintensities using the Fazekas criteria.
  
  
  RESULTS
  Both episodic memory and executive function demonstrated significant improvement among adults with late-life depression during treatment with sertraline. Importantly, older age, higher vascular risk scores, and lower baseline Mini-Mental State Examination scores predicted less change in working memory. Furthermore, older age, later age of onset, and higher vascular risk scores predicted less change in executive function.
  
  
  CONCLUSIONS
  These results have important clinical implications in that they suggest that a regular assessment of vascular risk in older adults with depression is necessary as a component of treatment planning and in predicting prognosis, both for the course of the depression itself and for the cognitive impairments that often accompany depression in later life.
authors.affiliation: Department of Psychology, Washington University School of Medicine, St. Louis, MO, USA.
authors.forename: Deanna M
authors.initials: DM
authors.lastname: Barch
authors.forename: Gina
authors.initials: G
authors.lastname: DʼAngelo
authors.forename: Carl
authors.initials: C
authors.lastname: Pieper
authors.forename: Consuelo H
authors.initials: CH
authors.lastname: Wilkins
authors.forename: Kathleen
authors.initials: K
authors.lastname: Welsh-Bohmer
authors.forename: Warren
authors.initials: W
authors.lastname: Taylor
authors.forename: Keith S
authors.initials: KS
authors.lastname: Garcia
authors.forename: Kenneth
authors.initials: K
authors.lastname: Gersing
authors.forename: P Murali
authors.initials: PM
authors.lastname: Doraiswamy
authors.forename: Yvette I
authors.initials: YI
authors.lastname: Sheline
mesh_terms: D017668:Age of Onset; D000368:Aged; D000928:Antidepressive Agents / Q000627:therapeutic use; D003072:Cognition Disorders / Q000150:complications*; D003863:Depression / Q000150:complications* / Q000188:drug therapy; D056344:Executive Function; D005260:Female; D006801:Humans; D008297:Male; D008568:Memory; D008609:Mental Status Schedule; D020280:Sertraline / Q000627:therapeutic use; D012720:Severity of Illness Index; D016896:Treatment Outcome; D014652:Vascular Diseases / Q000150:complications*
chemical_list: D000928:Antidepressive Agents; D020280:Sertraline