title: No evidence in favor of a more deleterious impact of a major depressive episode on verbal memory in older patients with antidepressant response.
abstract: BACKGROUND
  Older patients may be more vulnerable to the deleterious effect of depressive episodes on delayed narrative memory, a cognitive task which reflects hippocampal activity. We aimed to disentangle which factors could explain such increased vulnerability in the elderly, including the poorer response to treatment, a longer lifetime exposure to past depressive episodes, and lower baseline memory skills.
  
  
  METHODS
  From an initial sample of 8,229 depressed outpatients, we focused on the 2,424 treatment responders, and compared older (65 years old and over, N = 233) to younger (N = 2,191) ones. These patients were included through general practitioners' assessment and tested for the Wechsler delayed paragraph recall index, a valid and sensitive test assessing verbal declarative memory (and a marker of the hippocampal function), at baseline and after six weeks of treatment.
  
  
  RESULTS
  As expected, older patients after response to antidepressants showed decreased narrative memory abilities compared to younger ones. As baseline memory performance and residual depressive symptoms were also found in excess in this sample, they could act as confounders. Indeed, after controlling for these two factors, the role of age in memory performance after treatment response was ruled out.
  
  
  CONCLUSIONS
  The potential "toxicity" of a depressive episode to cognitive functions related to the hippocampus may not be more critical in older patients compared to younger ones. Limiting remaining depressive symptoms in older depressed patients might be a way to counteract the observed worsening of memory functions in depressed patients.
authors.affiliation: CMME (Groupe Hospitalier Sainte-Anne),Université Paris Descartes,Paris,France.
authors.forename: Elise
authors.initials: E
authors.lastname: Blandin
authors.affiliation: Secteur 17 Centre Hospitalier Sainte-Anne,23 rue Broussais 75014 Paris,France.
authors.forename: Guilhem
authors.initials: G
authors.lastname: Carle
authors.affiliation: SHU (Groupe Hospitalier Sainte-Anne),7 rue Cabanis,75014 Paris,France.
authors.forename: Benoit
authors.initials: B
authors.lastname: Theuil
authors.affiliation: AP-HP Hôpital H. Mondor-A. Chenevier,Pôle de Psychiatrie,Créteil 94000 Paris,France.
authors.forename: Julien
authors.initials: J
authors.lastname: Katz
authors.affiliation: CMME (Groupe Hospitalier Sainte-Anne),Université Paris Descartes,Paris,France.
authors.forename: Philip
authors.initials: P
authors.lastname: Gorwood
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000928:Antidepressive Agents / Q000009:adverse effects* / Q000627:therapeutic use; D003071:Cognition / Q000187:drug effects*; D003865:Major Depressive Disorder / Q000188:drug therapy*; D005260:Female; D006624:Hippocampus / Q000187:drug effects; D006801:Humans; D008297:Male; D011939:Mental Recall / Q000187:drug effects*; D009483:Neuropsychological Tests
chemical_list: D000928:Antidepressive Agents
keywords: age; depressive episodes; elderly patients; lifetime; memory impairment; neurotoxicity