Neurological findings in late-onset depressive disorder: comparison of individuals with and without depression

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Abstract
Background: Organic factors are thought to be important in late-life depressive disorder but there have been few studies specifically of neurological signs.Aims: To compare neurological signs in a group of patients with late-onset depression and in healthy controls.Method: A case–control study comparing 50 patients with depression and 35 controls on three measures of central nervous system (CNS) signs: a structured CNS examination, the Neurological Evaluation Scale (NES) and the Webster rating scale for parkinsonism.Results: After adjusting for major depression at the time of evaluation and prescription of tranquillisers, ratings on two of the NES sub-scales (complex motor sequencing and ‘other’ signs) and on the Webster scale were significantly higher (more impaired) in patients compared with controls (P <0.05). With logistic regression, the NES was the main measure predictive of group outcome. There were no differences in scores of vascular risk or white matter but patients had more atrophy.Conclusions: The findings add to the evidence that late-life depression is associated with organic brain dysfunction, perhaps mediated by neurodegeneration or subtle vascular impairment. The use of the NES in subjects with depression should be replicated.