title: Cognitive outcomes after psychotherapeutic interventions for major depression in older adults with executive dysfunction.
abstract: OBJECTIVE
  The purpose of this study was to determine the impact of psychotherapy on cognitive functioning in older adults with late-life depression (LLD) and executive dysfunction.
  
  
  METHODS
  Two hundred twenty-one adults aged 60 years and older participated in a randomized clinical trial comparing the efficacy of Problem Solving Therapy (PST) and Supportive Therapy (ST) for LLD. Cognitive performance on seven tests of executive functioning, verbal learning, and memory was evaluated at baseline, after 12 weeks of treatment, and at 24 weeks after the completion of treatment.
  
  
  RESULTS
  Performance on a measure of executive functioning with a significant information processing speed component (Stroop Color and Word Test) improved after treatment, F (1, 312) = 8.50, p = 0.002, and improved performance was associated with a reduction in depressive symptoms but not treatment type. Performance on other measures of executive functioning, verbal learning, and memory did not change significantly after 12 weeks of psychotherapy treatment.
  
  
  CONCLUSIONS
  Our results suggest that improvements in cognitive functioning after psychotherapy treatment for depression in older adults with executive dysfunction are likely focal and not distributed across all cognitive domains. Although previous analyses reported that PST was superior to ST in the treatment of depression, this analysis indicated no difference between the two treatments with regard to improvements in cognitive functioning.
authors.affiliation: Department of Psychiatry, University of California, San Francisco, San Francisco, CA; Center for Imaging of Neurodegenerative Disease, San Francisco, CA; Veterans Administration Medical Center, San Francisco, CA. Electronic address: scottm@lppi.ucsf.edu.
authors.forename: R Scott
authors.initials: RS
authors.lastname: Mackin
authors.affiliation: Department of Psychiatry, University of California, San Francisco, San Francisco, CA.
authors.forename: J Craig
authors.initials: JC
authors.lastname: Nelson
authors.affiliation: Department of Psychiatry, University of California, San Francisco, San Francisco, CA.
authors.forename: Kevin
authors.initials: K
authors.lastname: Delucchi
authors.affiliation: Department of Psychiatry, Weill Cornell Medical College, New York, NY.
authors.forename: Patrick
authors.initials: P
authors.lastname: Raue
authors.affiliation: Department of Psychiatry, University of California, San Francisco, San Francisco, CA; Veterans Administration Medical Center, San Francisco, CA.
authors.forename: Amy
authors.initials: A
authors.lastname: Byers
authors.affiliation: Department of Psychiatry, University of California, San Francisco, San Francisco, CA; Veterans Administration Medical Center, San Francisco, CA.
authors.forename: Deborah
authors.initials: D
authors.lastname: Barnes
authors.affiliation: Department of Psychiatry, University of California, San Francisco, San Francisco, CA; Kaiser Permanente Division of Research, Oakland, CA.
authors.forename: Derek D
authors.initials: DD
authors.lastname: Satre
authors.affiliation: Department of Psychiatry, University of California, San Francisco, San Francisco, CA; Veterans Administration Medical Center, San Francisco, CA.
authors.forename: Kristine
authors.initials: K
authors.lastname: Yaffe
authors.affiliation: Department of Psychiatry, Weill Cornell Medical College, New York, NY.
authors.forename: George S
authors.initials: GS
authors.lastname: Alexopoulos
authors.affiliation: Department of Psychiatry, University of California, San Francisco, San Francisco, CA.
authors.forename: Patricia A
authors.initials: PA
authors.lastname: Arean
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003072:Cognition Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy*; D015897:Comorbidity; D003865:Major Depressive Disorder / Q000453:epidemiology / Q000628:therapy*; D056344:Executive Function / Q000502:physiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011613:Psychotherapy / Q000379:methods*; D012720:Severity of Illness Index; D016896:Treatment Outcome
keywords: Cognitive functioning; executive dysfunction; information processing speed; late-life depression; learning; memory; mild cognitive impairment; psychotherapy