This Article  • Full text  • PDF  • Reply to article  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on ISI (104)  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Topic Collections  • Aging/ Geriatrics  • Depression  • Alert me on articles by topic

Balu Kalayam, MD; George S. Alexopoulos, MD

Arch Gen Psychiatry. 1999;56:713-718.

Background  This study investigated the relationship of clinical, neuropsychological, and electrophysiological measures of prefrontal dysfunction with treatment response in elderly patients with major depression.

Methods  Forty-nine depressed elderly subjects were studied before and after 6 weeks of adequate antidepressant treatment and compared with 22 psychiatrically normal controls. The psychomotor retardation item of the Hamilton Depression Rating Scale, the initiation/perseveration subscore of the Mattis Dementia Rating Scale, and the latency of the P300 auditory evoked potential were used as indices of prefrontal dysfunction. The intensity of antidepressant drug treatment was classified and monitored for a 6-week period.

Results  Abnormal initiation/perseveration score, psychomotor retardation, and long P300 latency predicted 58% of the variance in change of depression scores from baseline to 6 weeks (F₃=20.1, P<.001). Depressed patients who remained symptomatic (n=25) had more abnormal initiation/perseveration scores and longer P300 latency compared with depressed patients who achieved remission (n=24) and control subjects. There were no differences between the last 2 groups. The association between psychomotor retardation, initiation/perseveration scores, P300 latency, and response to antidepressant treatment could not be explained by differences in demographic and clinical characteristics or treatment intensity between remitted and nonremitted depressed patients.

Conclusions  Prefrontal dysfunction was associated with poor or delayed antidepressant response in depressed elderly patients. This observation, if confirmed, may aid clinicians in identifying candidates for aggressive somatic therapies and for interventions offering structure of daily activities.

From the Weill Medical College of Cornell University, White Plains, NY.

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Late-onset depression: issues affecting clinical care
Variend and Gopal
Adv. Psychiatr. Treat. 2008;14:152-158.
ABSTRACT | FULL TEXT  

Cognitive Predictors of Response to Treatment for Depression in Multiple Sclerosis
Julian and Mohr
J. Neuropsychiatry Clin. Neurosi. 2006;18:356-363.
ABSTRACT | FULL TEXT  

Increased Hippocampal Plaques and Tangles in Patients With Alzheimer Disease With a Lifetime History of Major Depression
Rapp et al.
Arch Gen Psychiatry 2006;63:161-167.
ABSTRACT | FULL TEXT  

Psychomotor Slowing as a Predictor of Fluoxetine Nonresponse in Depressed Outpatients
Taylor et al.
Am. J. Psychiatry 2006;163:73-78.
ABSTRACT | FULL TEXT  

Neuropsychological Differences Between Late-Onset and Recurrent Geriatric Major Depression
Rapp et al.
Am. J. Psychiatry 2005;162:691-698.
ABSTRACT | FULL TEXT  

Executive Deficits in Elderly Patients With Major Unipolar Depression
Baudic et al.
J Geriatr Psychiatry Neurol 2004;17:195-201.
ABSTRACT  

Risk Factors for Geriatric Depression: The Importance of Executive Functioning Within the Vascular Depression Hypothesis
Mast et al.
J. Gerontol. A Biol. Sci. Med. Sci. 2004;59:1290-1294.
ABSTRACT | FULL TEXT  

Late-Life Depression and Microstructural Abnormalities in Dorsolateral Prefrontal Cortex White Matter
Taylor et al.
Am. J. Psychiatry 2004;161:1293-1296.
ABSTRACT | FULL TEXT  

Does Antidepressant Therapy Improve Cognition in Elderly Depressed Patients?
Doraiswamy et al.
J. Gerontol. A Biol. Sci. Med. Sci. 2003;58:M1137-1144.
ABSTRACT | FULL TEXT  

Depression and Bipolar Support Alliance Consensus Statement on the Unmet Needs in Diagnosis and Treatment of Mood Disorders in Late Life
Charney et al.
Arch Gen Psychiatry 2003;60:664-672.
ABSTRACT | FULL TEXT  

Differential Brain Metabolic Predictors of Response to Paroxetine in Obsessive-Compulsive Disorder Versus Major Depression
Saxena et al.
Am. J. Psychiatry 2003;160:522-532.
ABSTRACT | FULL TEXT  

Frontal White Matter Microstructure and Treatment Response of Late-Life Depression: A Preliminary Study
Alexopoulos et al.
Am. J. Psychiatry 2002;159:1929-1932.
ABSTRACT | FULL TEXT  

Ischemic Basis for Deep White Matter Hyperintensities in Major Depression: A Neuropathological Study
Thomas et al.
Arch Gen Psychiatry 2002;59:785-792.
ABSTRACT | FULL TEXT  

Executive Dysfunction in Geriatric Depression
Lockwood et al.
Am. J. Psychiatry 2002;159:1119-1126.
ABSTRACT | FULL TEXT  

Hippocampal and Anterior Cingulate Activation Deficits in Patients With Geriatric Depression
de Asis et al.
Am. J. Psychiatry 2001;158:1321-1323.
ABSTRACT | FULL TEXT  

New Concepts for Prevention and Treatment of Late-Life Depression
Alexopoulos
Am. J. Psychiatry 2001;158:835-838.
FULL TEXT  

Medical urology.
VALE
Postgrad. Med. J. 2000;76:596-597.
FULL TEXT  

Executive Dysfunction and Long-term Outcomes of Geriatric Depression
Alexopoulos et al.
Arch Gen Psychiatry 2000;57:285-290.
ABSTRACT | FULL TEXT