title: Cognitive functioning throughout the treatment history of clinical late-life depression.
abstract: OBJECTIVE
  Previous investigations into the relationship between late-life depressive symptoms and cognitive functioning have resulted in mixed findings concerning whether or not depressive symptoms and cognitive functioning are related. The mixed reports may be due in part to differences in clinical and nonclinical samples and to inadequate consideration of the dynamic nature (i.e., fluctuating course) of depressive symptoms and cognitive functioning in older adults. The current study examined the chronic, acute, and longitudinal relationships between depressive symptoms and cognitive functioning in older adults in an ongoing treatment study of major depressive disorder (MDD).
  
  
  METHODS
  The neurocognitive outcomes of depression in the elderly study operates in a naturalistic treatment milieu using a pharmacological treatment algorithm and regular psychiatric assessment. Four hundred and fifty-three older adults [mean age 70 years, standard deviation (SD) = 7.2] meeting criteria for MDD at study enrollment received annual neuropsychological testing and depressive symptom monitoring for an average of 8.5 years (SD = 4.5).
  
  
  RESULTS
  Hierarchical linear modeling revealed that higher age, lower education, and higher average/chronic levels of depressive symptoms were related to lower cognitive functioning. Additionally, results revealed that when an individual's depressive symptoms are higher than is typical for a specific individual, general cognitive function was worse than average. There was no evidence of lagged/longitudinal relationships between depressive symptoms and cognitive functioning in older adults in treatment for MDD.
  
  
  CONCLUSIONS
  Cognitive functioning and depressive symptoms are concurrently associated in older adults with MDD, highlighting the potential importance for stabilizing mood symptoms as a means to manage cognitive deficits in late-life depression.
authors.affiliation: David Geffen School of Medicine, UCLA, Los Angeles, CA, USA.|Geriatric Research, Education and Clinical Center, Greater Los Angeles Veterans Affairs Healthcare System, Los Angeles, CA, USA.
authors.forename: Joseph M
authors.initials: JM
authors.lastname: Dzierzewski
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA.
authors.forename: Guy G
authors.initials: GG
authors.lastname: Potter
authors.affiliation: Department of Psychiatry and Human Behavior, Warren Alpert Medical School, Brown University, Providence, RI, USA.
authors.forename: Richard N
authors.initials: RN
authors.lastname: Jones
authors.affiliation: National Institute on Aging, Intramural Research Program, National Institutes of Health and Department of Psychiatry, University of Michigan, Anne Arbor, MI, USA.
authors.forename: Ola S
authors.initials: OS
authors.lastname: Rostant
authors.affiliation: Department of Psychology, University of Massachusetts Dartmouth, Dartmouth, MA, USA.
authors.forename: Brian
authors.initials: B
authors.lastname: Ayotte
authors.affiliation: Department of Biostatistics and Epidemiology, Medical College of Georgia, Georgia Regents University, Augusta, GA, USA.
authors.forename: Frances M
authors.initials: FM
authors.lastname: Yang
authors.affiliation: Department of Neurology, Wake Forest University Baptist Medical Center, Winston-Salem, NC, USA.
authors.forename: Bonnie C
authors.initials: BC
authors.lastname: Sachs
authors.affiliation: Partners for Children, School of Social Work, University of Washington, Seattle, WA, USA.
authors.forename: Betsy J
authors.initials: BJ
authors.lastname: Feldman
authors.affiliation: Department of Psychiatry, University of Connecticut, Farmington, CT, USA.
authors.forename: David C
authors.initials: DC
authors.lastname: Steffens
mesh_terms: D017668:Age of Onset; D000368:Aged; D000369:Aged, 80 and over; D003071:Cognition / Q000502:physiology*; D003072:Cognition Disorders / Q000150:complications / Q000523:psychology*; D003865:Major Depressive Disorder / Q000150:complications / Q000503:physiopathology / Q000523:psychology*; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests
keywords: cognitive functioning; depressive symptoms; longitudinal design; major depressive disorder; naturalistic study