Depression and cognitive deterioration in the elderly: A follow-up study.

Persistent Link:
http://hdl.handle.net/10150/185628
Title:
Depression and cognitive deterioration in the elderly: A follow-up study.
Author:
Nussbaum, Paul David.
Issue Date:
1991
Publisher:
The University of Arizona.
Rights:
Copyright © is held by the author. Digital access to this material is made possible by the University Libraries, University of Arizona. Further transmission, reproduction or presentation (such as public display or performance) of protected items is prohibited except with permission of the author.
Abstract:
The extent of cognitive deficit in depressed elderly remains unclear. Recent follow-up studies of elderly patients diagnosed as depressed suggest that depression may present as the initial sign of progressive dementia. This raises questions regarding the nature of the depression in those individuals who deteriorate cognitively over time, and encourages the search for clinical indicators of those depressed who are likely to deteriorate. Thirty-five depressed older adult outpatients were comprehensively examined and re-evaluated with a brief neuropsychological battery after one or more years. Twenty-three probable dementia of the Alzheimer's type patients (DAT) provided a comparison with a known progressive disorder. Patients with a decline of four points from their original score on a mental status examination comprised the "depressed with cognitive deterioration" sample (N = 8) and all others made up the "depressed without cognitive deterioration" sample (N = 27). These two samples were then compared on clinical variables from the initial neuropsychological, medical, radiological, and patient history examination. A Multivariate analysis of variance using the following variables: initial age, education, modified Hachinski, initial Mini-Mental State, Wechsler Memory Quotient, vocabulary, digit span, similarities, picture completion, block design, and digit symbol subtests of the Wechsler Adult Intelligence Scale-Revised, initial Geriatric Depression Scale, and Grocery Store Test of verbal fluency failed to differentiate those depressed elderly that declined from those who did not. A series of Chi-square analyses using the medical and radiological variables demonstrated a significant association between depressed with deterioration and magnetic resonance imaging (MRI) abnormalities, computerized tomography (CT) abnormalities, and Electrocardiogram (EKG) abnormalities. Those depressed patients with cognitive deterioration demonstrated a higher frequency of white matter abnormalities on the combined CT and MRI than did those depressed patients with no deterioration. Leuko-araiosis in depressed elderly may represent a clinical marker for the identification of later cognitive deterioration. Results indicate: (1) a need for the development of more sensitive neuropsychological measures for accurate prediction of deterioration; (2) the importance of follow-up neuropsychological evaluations on depressed elderly; (3) relationship between white matter abnormality and cognitive deterioration in depressed elderly, and (4) support for the hypothesis that depression may present as an early sign of a later developing progressive dementia.
Type:
text; Dissertation-Reproduction (electronic)
Keywords:
Older people -- Psychology; Depression in old age -- Case studies; Cognition in old age -- Case studies.
Degree Name:
Ph.D.
Degree Level:
doctoral
Degree Program:
Psychology; Graduate College
Degree Grantor:
University of Arizona
Advisor:
Kaszniak, Alfred W.

Full metadata record

DC FieldValue Language
dc.language.isoenen_US
dc.titleDepression and cognitive deterioration in the elderly: A follow-up study.en_US
dc.creatorNussbaum, Paul David.en_US
dc.contributor.authorNussbaum, Paul David.en_US
dc.date.issued1991en_US
dc.publisherThe University of Arizona.en_US
dc.rightsCopyright © is held by the author. Digital access to this material is made possible by the University Libraries, University of Arizona. Further transmission, reproduction or presentation (such as public display or performance) of protected items is prohibited except with permission of the author.en_US
dc.description.abstractThe extent of cognitive deficit in depressed elderly remains unclear. Recent follow-up studies of elderly patients diagnosed as depressed suggest that depression may present as the initial sign of progressive dementia. This raises questions regarding the nature of the depression in those individuals who deteriorate cognitively over time, and encourages the search for clinical indicators of those depressed who are likely to deteriorate. Thirty-five depressed older adult outpatients were comprehensively examined and re-evaluated with a brief neuropsychological battery after one or more years. Twenty-three probable dementia of the Alzheimer's type patients (DAT) provided a comparison with a known progressive disorder. Patients with a decline of four points from their original score on a mental status examination comprised the "depressed with cognitive deterioration" sample (N = 8) and all others made up the "depressed without cognitive deterioration" sample (N = 27). These two samples were then compared on clinical variables from the initial neuropsychological, medical, radiological, and patient history examination. A Multivariate analysis of variance using the following variables: initial age, education, modified Hachinski, initial Mini-Mental State, Wechsler Memory Quotient, vocabulary, digit span, similarities, picture completion, block design, and digit symbol subtests of the Wechsler Adult Intelligence Scale-Revised, initial Geriatric Depression Scale, and Grocery Store Test of verbal fluency failed to differentiate those depressed elderly that declined from those who did not. A series of Chi-square analyses using the medical and radiological variables demonstrated a significant association between depressed with deterioration and magnetic resonance imaging (MRI) abnormalities, computerized tomography (CT) abnormalities, and Electrocardiogram (EKG) abnormalities. Those depressed patients with cognitive deterioration demonstrated a higher frequency of white matter abnormalities on the combined CT and MRI than did those depressed patients with no deterioration. Leuko-araiosis in depressed elderly may represent a clinical marker for the identification of later cognitive deterioration. Results indicate: (1) a need for the development of more sensitive neuropsychological measures for accurate prediction of deterioration; (2) the importance of follow-up neuropsychological evaluations on depressed elderly; (3) relationship between white matter abnormality and cognitive deterioration in depressed elderly, and (4) support for the hypothesis that depression may present as an early sign of a later developing progressive dementia.en_US
dc.typetexten_US
dc.typeDissertation-Reproduction (electronic)en_US
dc.subjectOlder people -- Psychologyen_US
dc.subjectDepression in old age -- Case studiesen_US
dc.subjectCognition in old age -- Case studies.en_US
thesis.degree.namePh.D.en_US
thesis.degree.leveldoctoralen_US
thesis.degree.disciplinePsychologyen_US
thesis.degree.disciplineGraduate Collegeen_US
thesis.degree.grantorUniversity of Arizonaen_US
dc.contributor.advisorKaszniak, Alfred W.en_US
dc.contributor.committeememberBootzin, Richarden_US
dc.contributor.committeememberLansing, Roberten_US
dc.contributor.committeememberAllender, Jamesen_US
dc.contributor.committeememberSchacter, Danielen_US
dc.identifier.proquest9208027en_US
dc.identifier.oclc703888977en_US
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