Memory functioning in depressed and cognitively impaired elderly
Hoiland, Michael Vern
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The main purpose of this study was to examine memory performance cross-sectionally in a heterogeneous outpatient geriatric sample (N = 144) with significant depressive symptoms and mental status impairment using a memory test, Free and Cued selective Reminding (FCSR), which generates indices of Free Recall (FR) and Total Recall (Free + Cued Recall) (TR).;Subject's level of cognitive impairment was evaluated with The Blessed Mental Status Test (BMST), and depressive status was obtained using the Geriatric Depression Scale (GDS), Carroll Rating Scale (CRS), or physician diagnosis. Patients were divided into different groups (e.g. probable demented/not depressed (PDmNDp), probable demented/depressed (PDmDp), high risk for dementia/depressed (HrDp), high risk for dementia/not depressed (HrNDp), and low risk for dementia/depressed (LrDp), and low risk for dementia/not depressed (LrNDp), and compared on FR and TR.;Initial results were mixed: contrary to predictions, LrDp subjects (defined by GDS, CRS, or physician diagnosis) did not have decreased FR compared to LrNDp subjects, and the PDmDp and PDmNDp groups performed similarly on both FR and TR; consistent with expectations, the PDmNDp group, compared to the LrDp group, had lower FR and TR.;Follow-up analyses indicated that when only those cases with GDS defined depressive symptoms were included, a cutoff score of 6 produced maximum mean FR differences between LrDp and LrNDp groups. Moreover, the GDS depressed group performed similarly to the HrNDp group on both FR and TR, and the HrDp group (defined by GDS only) displayed higher FR compared to the HrNDp group.;Overall, these results solidly support the utility of FCSR for evaluating memory in diverse geriatric patients. Further, they underscore the growing need for more accurate assessment, treatment, and prediction of psychiatric problems and severe memory disturbance in this burgeoning segment of society.