Format

Send to

Choose Destination
Am J Geriatr Psychiatry. 2015 Dec;23(12):1270-1275. doi: 10.1016/j.jagp.2015.08.002. Epub 2015 Aug 20.

Relationship Between Cerebrovascular Risk, Cognition, and Treatment Outcome in Late-Life Psychotic Depression.

Author information

1
Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.
2
Western Psychiatric Institute and Clinic, Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA.
3
Department of Psychiatry, Weill Medical College of Cornell University and New York Presbyterian Hospital, Westchester Division, New York, NY.
4
Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada; Centre for Addiction and Mental Health, Toronto, Ontario, Canada.
5
University of Massachusetts Medical School and UMass Memorial Health Care, Worcester, MA.
6
Department of Healthcare Policy and Research, Weill Cornell Medical College, New York, NY.
7
Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada; Department of Psychiatry, University Health Network, Toronto, Ontario, Canada; Toronto General and Toronto Rehab Research Institutes, Toronto, Ontario, Canada. Electronic address: alastair.flint@uhn.ca.

Abstract

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.

KEYWORDS:

Vascular risk; executive function; major depressive disorder; processing speed; psychotic depression; treatment outcome

PMID:
26560512
PMCID:
PMC4691567
DOI:
10.1016/j.jagp.2015.08.002
[Indexed for MEDLINE]
Free PMC Article

Supplemental Content

Full text links

Icon for Elsevier Science Icon for PubMed Central
Loading ...
Support Center