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

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Abstract
Thirty-five depressed elderly subjects, who received comprehensive evaluations in a memory disorders clinic, were followed (mean of 24 months) and evaluated with a brief neuropsychological battery. Diagnoses were made by consensus of a board-certified neuropsychologist and neurologist. A deterioration of four points on follow-up Folstein MMSE, compared to initial MMSE (based on calculation of the standard error of difference), defined cognitive decline. Eight patients demonstrated cognitive decline and 27 did not. A MANOVA using initial neuropsychological, depression severity, and demographic variables did not differentiate the two groups. Chi-square analyses on medical and radiological data from the initial examination showed that those depressed subjects with decline had a greater number of abnormal MRIs, CTs, and EKGs. Results from MRI and CT demonstrated the presence of leuko-araiosis in the depressed patients with cognitive decline. Leuko-araiosis in some depressed elderly may contribute to their cognitive decline and dysphoric affect. Further, depression in some elderly may present the first sign of a later developing dementia.