Several studies have evaluated executive function in depressed patients, and the results vary from significant impairment relative to controls to virtually intact performances. To better comprehend executive impairment in elderly patients with major unipolar depression, the performance of 21 elderly depressed patients was compared with that of 19 elderly normal controls on executive tasks. The relationships between memory deficits and depression severity and between memory deficits and executive dysfunction were also examined. Depressed patients’ performance was significantly worse than that of controls on almost all executive tasks. Their score for logical memory was significantly correlated with that for several executive tasks. Executive performance was also correlated with depression severity. Unipolar depressed patients present executive deficits. Memory failure in these patients may reflect impairment in retrieval processes, which in turn depends on executive function. Executive deficits are associated with depression severity. These results may be useful in the differential diagnosis between depression and early Alzheimer’s disease.
1. Foster JK, Black SE, Buck BH, Bronskill MJ. Ageing and executive function: a neuroimaging perspective. In: Rabbitt P, ed. Methodology of Frontal and Executive Function. Hove, UK: Psychology Press, 1997:117-134.
2.
2. Shallice T.From Neuropsychology to Mental Structure. Cambridge, UK: Cambridge University Press, 1988.
3.
3. Dolan RJ, Bench CJ, Brown RG, et al. Regional cerebral blood flow abnormalities in depressed patients with cognitive impairment. J Neurol Neurosurg Psychiatry. 1992; 55:768-773.
4.
4. Boller F, Traykov L, Dao-Castellana M, et al. Cognitive functioning in “diffuse” pathology: role of prefrontal and limbic structures. Ann N Y Acad Sci.1995; 769:23-39.
6. Wolfe J, Granholm E, Butters N, et al. Verbal memory deficits associated with major affective disorders: a comparison of unipolar and bipolar patients. J Affect Disord. 1987; 13:83-92.
7.
7. Austin MP, Ross M, Murray C, et al. Cognitive function in major depression. J Affect Disord. 1992; 25:21-30.
8.
8. Palmer BW, Boone KB, Lesser IM, et al. Neuropsychological deficits among older depressed patients with predominantly psychological or vegetative symptoms. J Affect Disord. 1996; 41:17-24.
9.
9. Massman P, Delis D, Butters N, et al. The subcortical dysfunction hypothesis of memory deficits in depression: neuropsychological validation in a subgroup of patients. J Clin Exp Neuropsychology. 1992; 14:687-706.
10.
10. Boone KB, Lesser IM, Miller BL, et al. Cognitive functioning in older depressed outpatients: relationships of presence and severity of depression to neuropsychological test scores. Neuropsychology. 1995; 9:390-398.
11.
11. Murphy C, Alexopoulos G.Longitudinal association of initiation/perseveration and severity of geriatric depression. Am J Geriatr Psychiatry. 2004; 12:50-56.
12.
12. Lockwood K, Alexopoulos G, Kakuma T, Van Gorp W.Subtypes of cognitive impairment in depressed older adults. Am J Geriatr Psychiatry. 2000; 8:201-208.
13.
13. Alexopoulos G.Role of executive function in late-life depression. J Clin Psychiatry. 2003; 64:18-23.
14.
14. Ellis HC, Ashbrook PW. Resource allocation model of the effect of depressed mood states on memory. In: Fiedler K, Forgas J, eds. Affect, Cognition and Social Behavior. Toronto, Ont: Hogrefe, 1988.
15.
15. Montgomery SA, Asberg M.A new depression scale designed to be sensitive to change. Br J Psychiatry. 1979; 134:282-289.
16.
16. Yesavage JA, Brink TL, Rose TL. Development and validation of a Geriatric Depression Screening Scale: a preliminary report. J Psychiatr Res.1983; 17:37-49.
17.
17. Widlöcher DJ. Psychomotor retardation: clinical, theoretical and psychometric aspects. Psychiatr Clin North Am. 1983; 6:27-40.
18.
18. Folstein ME, Folstein SE, McHugh PR. Mini mental state, a practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res.1975; 12:189-198.
19.
19. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 4th ed.Washington, DC: American Psychiatric Association, 1994.
20.
20. Ramier AM, Hécaen H.Rôle respectif des atteintes frontales et de la latéralisation lésionnelle dans les déficits de la “fluence verbale.” Rev Neurol. 1970; 123:17-22.
21.
21. Shallice T, Evans ME. The involvement of the frontal lobes in cognitive estimation. Cortex. 1978; 14:294-303.
22.
22. Burgess PW, Shallice T.Response suppression, initiation and strategy use following frontal lobe lesions. Neuropsychologia. 1996; 34:263-273.
23.
23. Golden CJ. Stroop Color and Word Test: A Manual for Clinical and Experimental Uses. Chicago, Ill: Stoelting, 1978.
24.
24. Reitan RM. Validity of the Trail Making Test as an indicator of organic brain damage. Percept Mot Skills. 1958; 8:271-276.
25.
25. Luria AR. Higher Cortical Functions in Man. New York: Basic Books, 1966.
26.
26. Nelson HE. A modified Card Sorting Test sensitive to frontal lobe defects. Cortex1976; 12:313-324.
28. Milner B.Interhemispheric differences in the localization of psychological processes in man. Br Med Bull.1971; 27:272-277.
29.
29. Alexopoulos GS, Meyers BS, Young RC, et al. Executive dysfunction and long-term outcomes of geriatric depression. Arch Gen Psychiatry. 2000; 57:285-290.
30.
30. Kalayam B, Alexopoulos GS. Prefrontal dysfunction and treatment response in geriatric depression. Arch Gen Psychiatry. 1999; 56:713-718.
32. Fletcher PC, Shallice T, Frith CD, et al. The functional roles of prefrontal cortex in episodic memory: II. Retrieval. Brain. 1998; 121:1249-1256.
33.
33. Fletcher PC, Shallice T, Dolan RJ, et al. The functional roles of prefrontal cortex in episodic memory: I. Encoding. Brain. 1998; 121:1239-1248.
34.
34. Fossati P, Coyette F, Ergis A, Allilaire J.Influence of age and executive functioning on verbal memory of inpatients with depression. J Affect Disord. 2002; 68:261-271.
35.
35. Fossati P, Harvey P, Le Bastard G, et al. Verbal memory performance of patients with a first depressive episode and patients with unipolar and bipolar recurrent depression. J Psychiatr Res.2004; 38:137-144.
36.
36. De Asis J, Stern E, Alexopoulos G, et al. Hippocampal and anterior cingulate activation deficits in patients with geriatric depression. Am J Psychiatry. 2001; 158:1321-1323.
37.
37. Degl’Innocenti A, Argen H, Bäckman L.Executive deficits in major depression. Acta Psychiatr Scand.1998; 97:182-188.
38.
38. Merriam EP, Thase ME, Haas GL, et al. Prefrontal cortical dysfunction in depression determined by Wisconsin Card Sorting Test performance. Am J Psychiatry. 1999; 156:780-782.
39.
39. Nebes R, Butters M, Houck P, et al. Dual-task performance in depressed geriatric patients. Psychiatry Res.2001; 102:139-151.
40.
40. Alexopoulos GS, Meyers BS, Young RC, et al. Recovery in geriatric depression. Arch Gen Psychiatry. 1996; 53:305-312.
