Relationship Between Cerebrovascular Risk, Cognition, and Treatment Outcome in Late-Life Psychotic Depression
Department of Psychiatry
Geriatrics | Mental Disorders | Psychiatry
OBJECTIVE: To examine whether cerebrovascular risk, executive function, and processing speed are associated with acute treatment outcome of psychotic depression in older adults.
METHODS: The authors analyzed data from 142 persons aged 60 years or older with major depression with psychotic features who participated in a 12-week randomized controlled trial (RCT) comparing olanzapine plus sertraline with olanzapine plus placebo. The independent variables were baseline cerebrovascular risk (Framingham Stroke Risk Score), baseline executive function (Stroop interference score and the initiation/perseveration subscale of the Mattis Dementia Rating Scale), and baseline processing speed (color and word reading components of the Stroop). The outcome variable was change in severity of depression, measured by the 17-item Hamilton Depression Rating Scale total score, during the course of the RCT.
RESULTS: Greater baseline cerebrovascular risk was significantly associated with less improvement in depression severity over time, after controlling for pertinent covariates. Neither executive function nor processing speed predicted outcome.
CONCLUSION: This study suggests an association of cerebrovascular risk, but not executive function or processing speed, with treatment outcome of major depression with psychotic features in older adults.
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Citation: Am J Geriatr Psychiatry. 2015 Dec;23(12):1270-5. doi: 10.1016/j.jagp.2015.08.002. Epub 2015 Aug 20. Link to article on publisher's site
Vascular risk, executive function, major depressive disorder, processing speed, psychotic depression, treatment outcome
Bingham, Kathleen S.; Whyte, Ellen M.; Meyers, Barnett S.; Mulsant, Benoit H.; Rothschild, Anthony J.; Banerjee, Samprit; Flint, Alastair; and STOP-PD Study Group, "Relationship Between Cerebrovascular Risk, Cognition, and Treatment Outcome in Late-Life Psychotic Depression" (2015). University of Massachusetts Medical School Faculty Publications. 942.