Clinical presentation of the "depression-executive dysfunction syndrome" of late life

被引:255
作者
Alexopoulos, GS [1 ]
Kiosses, DN [1 ]
Klimstra, S [1 ]
Kalayam, B [1 ]
Bruce, ML [1 ]
机构
[1] Cornell Univ, Joan & Sanford I Weill Med Coll, White Plains, NY 10605 USA
关键词
D O I
10.1176/appi.ajgp.10.1.98
中图分类号
R592 [老年病学]; C [社会科学总论];
学科分类号
03 ; 0303 ; 100203 ;
摘要
It has been proposed that a "depression-executive dysfunction (DED) syndrome" occurs in late life. This assertion was based on clinical, neuropathological, and neuroimaging findings suggesting that frontostriatal dysfunctions contribute to the development of bot depression and executive dysfunction and influence the course of depression. The authors describe the clinical presentation of DED and its relationship to disability studying 126 elderly subjects with major depression and evaluating depressive symptoms, cognitive functioning, disability and personality dimensions. Patients with the DED syndrome bad reduced fluency, impaired visual naming, paranoia, loss of interest in activities, and psychomotor retardation, but showed a rather mild vegetative syndrome. Depressive symptomatology and especially psychomotor retardation and loss of interest in activities, contributed to disability in DED patients, whereas paranoia was associated with disability independently of executive dysfunction. These findings may aid clinicians in identifying patients needing vigilant follow-up, because depression with executive dysfunction was found to be associated with disability, poor treatment response, relapse, and recurrence.
引用
收藏
页码:98 / 106
页数:9
相关论文
共 65 条
[1]  
Alexopoulos GS, 1997, ARCH GEN PSYCHIAT, V54, P915
[2]   Executive dysfunction and long-term outcomes of geriatric depression [J].
Alexopoulos, GS ;
Meyers, BS ;
Young, RC ;
Kalayam, B ;
Kakuma, T ;
Gabrielle, M ;
Sirey, JA ;
Hull, J .
ARCHIVES OF GENERAL PSYCHIATRY, 2000, 57 (03) :285-290
[3]  
ALEXOPOULOS GS, 2001, AM J GERIAT PSYCHIAT, V9, P1
[4]  
ANDREASEN NC, 1977, ARCH GEN PSYCHIAT, V34, P1229
[5]  
Benton A., 1974, The revised visual retention test
[6]  
Benton AL., 1976, MULTILINGUAL APHASIA
[7]   NEUROPSYCHOLOGICAL CORRELATES OF WHITE-MATTER LESIONS IN HEALTHY ELDERLY SUBJECTS - A THRESHOLD EFFECT [J].
BOONE, KB ;
MILLER, BL ;
LESSER, IM ;
MEHRINGER, CM ;
HILLGUTIERREZ, E ;
GOLDBERG, MA ;
BERMAN, NG .
ARCHIVES OF NEUROLOGY, 1992, 49 (05) :549-554
[8]   FRONTAL-CORTEX AND BASAL GANGLIA METABOLIC RATES ASSESSED BY POSITRON EMISSION TOMOGRAPHY WITH [F-18] 2-DEOXYGLUCOSE IN AFFECTIVE-ILLNESS [J].
BUCHSBAUM, MS ;
WU, J ;
DELISI, LE ;
HOLCOMB, H ;
KESSLER, R ;
JOHNSON, J ;
KING, AC ;
HAZLETT, E ;
LANGSTON, K ;
POST, RM .
JOURNAL OF AFFECTIVE DISORDERS, 1986, 10 (02) :137-152
[9]  
CLONINGER GR, 1987, TRIPARTITE PERSONALI
[10]  
Coffey C E, 1989, J Neuropsychiatry Clin Neurosci, V1, P135