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The nature and determinants of neuropsychological functioning in late-life depression
Butters MA, Whyte EM, Nebes RD, Begley AE, Dew MA, Mulsant BH, Zmuda MD, Bhalla R et al.. Archives of general psychiatry, 2004-06-01
Topic: Risk, prevention and care in population studies
Context Cognitive impairment in late-life depression (LLD) is highly prevalent, disabling, poorly understood, and likely related to long-term outcome. Objectives To determine the characteristics and determinants of neuropsychological functioning LLD. Design Cross-sectional study of groups of LLD patients and control subjects. Setting Outpatient, university-based depression research clinic. Participants One hundred patients without dementia 60 years and older who met DSM-IV criteria for current episode of unipolar major depression (nonpsychotic) and 40 nondepressed, age- and education-equated control subjects. Main outcome measures A comprehensive neuropsychological battery. Results Relative to control subjects, LLD patients performed poorer in all cognitive domains. More than half exhibited significant impairment (performance below the 10th percentile of the control group). Information processing speed and visuospatial and executive abilities were the most broadly and frequently impaired. The neuropsychological impairments were mediated almost entirely by slowed information processing (beta =.45-.80). Education (beta =.32) and ventricular atrophy (beta =.28) made additional modest contributions to variance in measures of language ability. Medical and vascular disease burden, apolipoprotein E genotype, and serum anticholinergicity did not contribute to variance in any cognitive domain. Conclusions Late-life depression is characterized by slowed information processing, which affects all realms of cognition. This supports the concept that frontostriatal dysfunction plays a key role in LLD. The putative role of some risk factors was validated (eg, advanced age, low education, depression severity), whereas others were not (eg, medical burden, age at onset of first depressive episode). Further studies of neuropsychological functioning in remitted LLD patients are needed to parse episode-related and persistent factors and to relate them to underlying neural dysfunction.
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APA 7th
Butters, M. A., Whyte, E. M., Nebes, R. D., Begley, A. E., Dew, M. A., Mulsant, B. H., et al. (2004). The nature and determinants of neuropsychological functioning in late-life depression. Archives of general psychiatry. https://doi.org/10.1001/archpsyc.61.6.587
Vancouver
Butters MA, Whyte EM, Nebes RD, Begley AE, Dew MA, Mulsant BH, et al. The nature and determinants of neuropsychological functioning in late-life depression. Archives of general psychiatry. 2004. doi:10.1001/archpsyc.61.6.587. PMID: 15184238.
BibTeX
@article{butters2004-15184238,
author = {Butters, M. A. and Whyte, E. M. and Nebes, R. D. and Begley, A. E. and Dew, M. A. and Mulsant, B. H. and Zmuda, M. D. and Bhalla, R. and others},
title = {{The nature and determinants of neuropsychological functioning in late-life depression}},
journal = {Archives of general psychiatry},
year = {2004},
doi = {10.1001/archpsyc.61.6.587},
pmid = {15184238},
url = {https://doi.org/10.1001/archpsyc.61.6.587}
}
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Key findings
- Results Relative to control subjects, LLD patients performed poorer in all cognitive domains.
- More than half exhibited significant impairment (performance below the 10th percentile of the control group).
Why it matters
In this cross-sectional study, older adults with major depression without dementia performed worse than controls in all cognitive domains, with slowed information processing explaining most of the impairment. This is about cognition in late-life depression, not about treating, curing or preventing Alzheimer's disease.
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Study details
- Study designcross-sectional
- Evidence strengthLow
How this study scored 55/100
Published in a peer-reviewed journal, and it is a snapshot of people at one point in time. Scored zero for sample size, effect reported, studied in people and randomized / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (Archives of general psychiatry) |
| Journal's citation record | 4 / 4 | Archives of General Psychiatry: journal h-index 543 (OpenAlex, 2026-10-29) |
| Study design | 4 / 12 | A snapshot of people at one point in time |
| Strength of evidence | 1 / 5 | Rated “low” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 1 / 5 | 2004 — older than 20 years, still counted |
| Sample size | 0 / 4 | Participant count not stated — scores zero (not stated in the record — scored 0) |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 0 / 3 | Not stated whether this was studied in people — scores zero (not stated in the record — scored 0) |
| Randomized / blinded | 0 / 2 | No randomization or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 6 / 7 | Cited 622 times (OpenAlex, 2026-10-10) |
| Citations per year | 4 / 5 | 25.9 citations a year over 24 year(s) since 2004 |
| Impact for its field and year | 4 / 6 | Cited 10.3× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 3 / 6 | Cited by 13 other studies in this library |
| Still being cited | 3 / 4 | Cited 59 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 4 / 4 | Last-listed author James T. Becker: h-index 104 (OpenAlex, whole career) |
| Institution's track record | 1 / 3 | University of Pittsburgh: institution h-index 1,470 (OpenAlex) |
| Multicenter collaboration | 1 / 3 | OpenAlex lists 2 institution(s) in 1 country |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 15184238) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Total | 55 / 100 | — |
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