The impact of cognitive function on medication management: three studies. Relationship of Cognition to Clinical Response in First-Episode Schizophrenia Spectrum Disorders. Effect of antidepressant treatment on cognitive impairments associated with depression: a randomised longitudinal study. Changes in cognitive functioning following treatment of late-life depression. Clinical and Cognitive Insight in a Compensatory Cognitive Training Intervention Two different sides of 'chemobrain': determinants and nondeterminants of self-perceived cognitive dysfunction in a prospective, randomized, multicenter study. The Effects of a Comprehensive Rehabilitation Program of Alzheimer’s Disease in a Hospital Setting Evaluating two group programmes of cognitive training in mild-to-moderate AD: Is there any difference between a ‘global’ stimulation and a ‘cognitive-specific’ one? Dose-dependent changes in cognitive function with exercise augmentation for major depression: Results from the TREAD study Compensatory cognitive training for psychosis: effects in a randomized controlled trial. Computer-based cognitive intervention for dementia: preliminary results of a randomized clinical trial. Executive Dysfunction and the Course of Geriatric Depression Cognitive training in affective disorders improves memory: a preliminary study using the NEAR approach. Non-Pharmacological Treatment in People With Cognitive Impairment. Cognitive complaints after breast cancer treatments: examining the relationship with neuropsychological test performance. One-year repeated cycles of cognitive training (CT) for Alzheimer’s disease Persistence of cognitive impairment in geriatric patients following antidepressant treatment: a randomized, double-blind clinical trial with nortriptyline and paroxetine.
OBJECTIVE Medication nonadherence has been a persistent problem over the past three decades ; forgetting and being distracted from regular routines are the barriers most frequently cited by patients . Prior research on cognitive function and medication adherence has yielded mixed results . DESIGN This report compares findings of three studies : All were longitudinal , two were r and omized controlled intervention trials , and one was descriptive . Sample s of adult patients taking once daily lipid-lowering medication , diabetic patients with comorbid conditions on complex regimens , and early stage breast cancer patients on hormonal therapy  completed similar batteries of st and ardized , valid , neuropsychological tests at baseline . MAIN OUTCOME MEASURES Adherence to medication regimens , over time , was tracked with electronic event monitors . RESULTS Medication nonadherence was prevalent in all studies . Deficits in attention/mental flexibility and /or working memory predicted nonadherence in all studies ; impaired executive function was related to poor adherence in one study . CONCLUSION These findings suggest that better mental efficiency may be the key to better medication adherence with any regimen , and that targeted cognitive functions , which can be easily and quickly assessed , may identify patients at risk of poor adherence regardless of diagnosis or regimen First-episode schizophrenia ( FES ) spectrum disorders are associated with pronounced cognitive dysfunction across all domains . However , less is known about the course of cognitive functioning , following the first presentation of psychosis , and the relationship of cognition to clinical course during initial treatment . The present longitudinal study examined the magnitude of neurocognitive impairment , using the MATRICS Consensus Cognitive Battery , in patients experiencing their first episode of psychosis at baseline and after 12 weeks of r and omized antipsychotic treatment with either aripiprazole or risperidone .  At baseline , FES patients evidence d marked impairments in cognitive functioning . Notably , performance on the mazes task of planning and reasoning significantly predicted the likelihood of meeting stringent criteria for positive symptom remission during the first 12 weeks of the trial . Performance on indices of general cognitive function , working memory , and verbal learning improved over time , but these improvements were mediated by improvements in both positive and negative symptoms . We did not detect any differential effects of antipsychotic medication assignment ( aripiprazole vs risperidone ) on cognitive functioning . Our results suggest that a brief paper- and -pencil measure reflecting planning/reasoning abilities may index responsivity to antipsychotic medication . However , improvements in cognitive functioning over time were related to clinical symptom improvement , reflecting " pseudospecificity . BACKGROUND Antidepressant treatment failure is a common problem worldwide . In this study , we assess whether or not an important aspect of depression , cognitive impairment , is untreated by antidepressants by study ing the effect of acute antidepressant treatment on a range of cognitive domains . METHODS In this r and omised longitudinal study , which is part of the International Study to Predict Optimized Treatment in Depression ( iSPOT-D ) trial , we assessed the effects of acute antidepressant treatment in a large patient population , across clinical remission outcomes , on a range of cognitive domains : attention , response inhibition , executive function during visuospatial navigation , cognitive flexibility , verbal memory , working memory , decision speed , information processing speed , and psychomotor response speed . We enrolled patients from primary or specialty care clinics in a multicentre , international , open-label , r and omised , prospect i ve trial . Eligible patients ( aged 18 - 65 years ) were previously untreated or were willing to undergo a 1-week medication washout before the study start , and could not have had inadequate response to study medications in the past . We enrolled a large population of medication-free ( ie , untreated ) out patients in a depressive episode and assessed them for cognitive function at enrolment ( pre-treatment ) , and again after 8 weeks of treatment with one of three antidepressant drugs ( escitalopram , sertraline , or venlafaxine extended-release ) . Patients were r and omly assigned ( 1:1:1 ) to one of the three antidepressants using a blocked r and omisation procedure ( block size of 12 ) . As a comparison group , we also simultaneously enrolled matched healthy participants . Healthy participants received no medication or intervention , but were assessed for change in cognitive and clinical measures during the same interval and testing protocol . Therefore , this group acts as a test-retest control for the primary outcome measure examined in this study , change in cognitive measures over 8 weeks of treatment in depressed patients . This study is registered with Clinical Trials.gov , number NCT00693849 . FINDINGS Between Dec 8 , 2008 , and Sept 30 , 2011 , we enrolled 1008 eligible people into the study .  Impairment in five domains-attention , response inhibition , verbal memory , decision speed , and information processing-showed no relative improvement with acute treatment ( controlling for time or repeated testing ) , irrespective of antidepressant treatment group , even in patients whose depression remitted acutely according to clinical measures . Broader cognitive impairment was associated with greater illness chronicity ( earlier illness onset ) but not with symptom severity or previous antidepressant failures . INTERPRETATION Depression is associated with impairments in higher-order cognitive functions and information processing , which persist independently of clinical symptom change with treatment . We recorded no difference between the three antidepressants tested , with none showing efficacy for these impairments . Although the 8-week treatment period limits interpretation to acute treatment effects , it does highlight cognitive impairment as an untargeted contributor to incomplete treatment success . FUNDING Brain Re source Company Operations Pty Ltd and NIH OBJECTIVE Knowledge of the relationship between various clinical characteristics and cognitive functioning is advancing , but little is known about the cognitive response to treatment for geriatric depression . The purpose of this study was to examine the cognitive response to treatment for patients with late-life depression . METHOD Subjects included 45 nondemented , elderly depressed patients who achieved remission after 12 weeks of antidepressant treatment and 20 elderly comparison subjects .  All subjects were administered a battery of clinical measures , including cognitive screening instruments , before and after treatment . RESULTS As a group , the elderly depressed patients showed a small improvement in overall cognitive functioning after treatment . Among depressed patients with concomitant cognitive impairment at baseline , performance on the Mattis Dementia Rating Scale domains of conceptualization and initiation/perseveration improved significantly relative to those of depressed patients with normal cognition . Despite the improvement following treatment , the overall level of cognitive functioning in the elderly depressed patients with cognitive impairment at baseline remained mildly impaired , especially in the memory and initiation/perseveration domains . CONCLUSIONS Elderly depressed patients with cognitive impairment may experience improvement in specific domains following antidepressant treatment but may not necessarily reach normal levels of performance , particularly in memory and executive functions . This subgroup of late-life depression patients is likely at high risk of developing progressive dementia The impact of limited insight is a crucial consideration in the treatment of individuals with psychiatric illness . In the context of psychosis , both clinical and cognitive insight have been described . This study aim ed to evaluate the relationships between clinical and cognitive insight and neuropsychological functioning , psychiatric symptom severity , and everyday functioning in patients with a primary psychotic disorder participating in a compensatory cognitive training ( CT ) intervention . Sixty-nine individuals diagnosed with a primary psychotic disorder were r and omized to a 3-month CT intervention or to st and ard pharmacotherapy , and they completed a comprehensive neuropsychological , clinical , and functional battery at baseline , 3 months , and 6 months . The CT intervention focused on habit formation and compensatory strategy learning in four domains : prospect i ve memory , attention and vigilance , learning and memory , and problem-solving/cognitive flexibility . At baseline , better clinical insight was significantly related to better executive functioning and less severe negative symptoms . There was no significant association between cognitive insight and cognitive functioning , symptom severity , or everyday functioning ability . The CT intervention did not have an effect on clinical or cognitive insight , but better cognitive insight prior to participation in CT significantly predicted decreased positive and depressive symptom severity posttreatment , and better clinical insight predicted improved self-reported quality of life . Although clinical insight is related to executive functioning , the correlates of cognitive insight remain elusive . Intact insight appears to be beneficial in ameliorating clinical symptomatology like positive symptoms and depression , rather than augmenting cognition . It may be valuable to develop brief interventions aim ed at improving clinical and cognitive insight prior to other psychosocial rehabilitation in order to maximize the benefit of treatment OBJECTIVE Complaints of cognitive dysfunction are frequent among cancer patients . Many studies have identified neuropsychological compromise associated with cancer and cancer therapy ; however , the neuropsychological compromise was not related to self-reported cognitive dysfunction . In this prospect i ve study , the authors examined if confounding factors masked an underlying association of self-perceived cognitive function with actual cognitive performance . Determinants of self-perceived cognitive dysfunction were investigated . METHODS Self-perceived cognitive function and cognitive performance were assessed before treatment , at the end of treatment , and 1 year after baseline in 101 breast cancer patients r and omized to st and ard versus intensified chemotherapy .  Linear mixed-effects models were applied to test the relationships of performance on neuropsychological tests , patient characteristics , and treatment variables to self-reported cognitive function . Change of cognitive performance was tested as a predictor of change in self-reports . RESULTS Self-perceived cognitive function deteriorated during chemotherapy and had partially recovered 1 year after diagnosis . The personality trait negative affectivity , current depression , and chemotherapy regimen were consistently related to cognitive self-reports . No significant associations with performance in any of the 12 cognitive tests emerged . Change of cognitive performance was not reflected in self-reports of cognitive function . CONCLUSIONS Neuropsychological compromise and self-perceived cognitive dysfunction are independent phenomena in cancer patients . Generally , cancer-associated neuropsychological compromise is not noticed by affected patients , but negative affectivity and treatment burden induce pessimistic self- appraisal s of cognitive functioning regardless of the presence of neuropsychological compromise . Clinicians should consider this when determining adequate therapy for patients who complain of ' chemobrain ' Introduction . The evidence for the clinical effectiveness of cognitive rehabilitation in patients with Alzheimer ’s Disease ( AD ) is debated . Therefore it is important to collect more evidence about the outcome of non-pharmacological therapy of dementia . Material and Methods . We report data concerning the rehabilitation of 50 patients with probable AD admitted during a 17-month period in a specialized unit . Participants were affected by dementia ranging from mild to severe . The patients were treated with the Reality Orientation Therapy ( ROT ) , integrated , when needed , with individualised cognitive approaches . The results concern : the cognitive status , evaluated by means of the Mini Mental State Examination ( MMSE ) , the functional status , evaluated with the Activity of Daily Living ( ADL ) scale , the assessment of psychological and behavioural disorders measured with the Neuropsychiatry Inventory ( NPI ) . The cognitive , functional , and psychopathological assessment s were administered at admission and discharge . Results . The mean MMSE scores at admission and discharge were respectively 16.06 and 17.54 ( Wilcoxon Ranks Test : p = 0.005 ) . Mean ADL scores were 4.86 at admission and 5.02 at discharge ( p = 0.011 ) . Mean NPI scores were respectively 21.46 and 12.26 ( p = < 0.001 ) . Conclusions . This survey of the 17-month experience suggests that a comprehensive treatment program may have beneficial effects on cognitive , functional , and in particular neuropsychiatric outcomes . The results should be verified with a r and omised clinical trial This study evaluated the efficacy of two different group procedures of non-pharmacological treatment in mild-to-moderate Alzheimer 's disease ( AD ) . Thirty-two patients entered the study and were divided in groups of four subjects . We compared recreational activities ( ‘ global ’ stimulation ) with a combination of procedural memory training on activities of daily living and neuropsychological rehabilitation of ‘ residual ’ functions ( ‘ cognitive-specific ’ ) .  All patients and caregivers were ensured psychological support . Both group treatments were delivered for six weeks . Multidimensional efficacy assessment of functional , behavioural and neuropsychological aspects was performed . Patients receiving ‘ global ’ stimulation showed a substantial reduction in behavioural disturbances ( Neuropsychiatric Inventory [ NPI ] : frequency p = 0.034 ; severity p = 0.012 ) ; Revised Memory Behaviour Problems Checklist ( frequency p = 0.008 ; reaction p = 0.027 ) , and better performance in the Functional Living Skills Assessment ( FLSA ) , a st and ardized direct measure of performance in everyday life ( p = 0.021 ) and Verbal Fluency for Letters ( p = 0.000 ) . Patients receiving ‘ cognitive-specific ’ treatment improved only on the scale evaluating functional competence in daily living ( Nurses ’ Observation Scale for Geriatric Patients [ NOSGER ] p = 0.018 ) . At follow-up ( six months later ) , compared with baseline , patients following the ‘ global ’ stimulation treatment showed an improvement at caregiver distress on NPI ( p = 0.04 ) . No other significant difference was detected . Our results support the contention that a ‘ global ’ treatment can lead to a significant improvement in AD patients , both for behavioural and functional aspects . The ‘ cognitive-specific ’ treatment we used in this research did not show better efficacy Cognitive dysfunction has been repeatedly observed in major depressive disorder ( MDD ) , particularly in areas of attention , verbal and nonverbal learning and memory , and executive functioning . Exercise has been shown to improve cognitive outcomes in other population s , including age-associated cognitive decline , but has not to our knowledge been investigated as an augmentation strategy in depression . This study evaluated the effectiveness of exercise augmentation on cognitive performance in persons with MDD and residual symptoms that included cognitive complaints following initial treatment with a selective  serotonin reuptake  inhibitor ( SSRI ) . Participants enrolled in the Treatment with Exercise Augmentation for Depression ( TREAD ) study were r and omized to receive either a low or high dose exercise regimen . TREAD participants who provided informed consent for the current study completed Cambridge Neuropsychological Test Automated Battery measures assessing Attention , Visual Memory , Executive Function/Set-shifting and Working Memory , and Executive Function/Spatial Planning domains . Data were analyzed for 39 participants completing both baseline and Week 12 cognitive testing . Overall tests indicated a significant task × group × time interaction for the Executive Function/Set-shifting and Working Memory domain . Post-hoc tests indicated improvements in high dose exercisers ' spatial working memory , but decreases in spatial working memory and set-shifting outcomes in low dose exercisers . Both groups improved on measures of psychomotor speed , attention , visual memory and spatial planning . This study suggests a dose-response effect of exercise in specific executive function and working memory tasks among depressed persons with a partial response to SSRI and cognitive complaints , with some cognitive functions improving regardless of exercise dose OBJECTIVE Treatments for the cognitive impairments of schizophrenia are urgently needed . We developed and tested a 12-week , group-based , manualized , compensatory cognitive training intervention targeting prospect i ve memory , attention , learning/memory , and executive functioning . The intervention focused on compensatory strategies , such as calendar use , self-talk , note taking , and a 6-step problem-solving method , and did not require computers . METHOD In a r and omized controlled trial , 69 out patients with DSM-IV primary psychotic disorders were assigned to receive st and ard pharmacotherapy alone or compensatory cognitive training + st and ard pharmacotherapy for 12 weeks . Assessment s of neuropsychological performance and functional capacity ( primary outcomes ) and psychiatric symptom severity , quality of life , social skills performance , cognitive insight , and self-reported everyday functioning ( secondary outcomes ) were administered at baseline , posttreatment , and 3-month follow-up . Data were collected between September 2003 and August 2009 . RESULTS Hierarchical linear modeling analyses demonstrated significant compensatory cognitive training-associated effects on attention at follow-up ( P = .049 ) , verbal memory at posttreatment and follow-up ( P values ≤ .039 ) , and functional capacity ( University of California , San Diego Performance-based Skills Assessment ) at follow-up ( P = .004 ) . The compensatory cognitive training group also differentially improved in negative symptom severity at posttreatment and follow-up ( P values ≤ .025 ) and subjective quality of life at follow-up ( P = .002 ) . CONCLUSIONS Compensatory cognitive training , a low-tech , brief intervention , has the potential to improve not only cognitive performance but also functional skills , negative symptoms , and self-rated quality of life in people with psychosis . TRIAL REGISTRATION Clinical Trials.gov identifier : NCT01521026 Dementia is a highly invalidating condition and , given the progressive aging of the population , one of the major issues that health systems will have to face in future years . Recently there has been an increase in the potential of diagnostic tools and pharmacological treatments for dementia ; moreover , considerable interest has been expressed regarding non pharmacological interventions . However , the current evidence in support of non pharmacological treatments in patients affected by dementia still does not allow to draw definitive conclusions on what is the most effective treatment to apply , largely because of method ological difficulties and limitations of the studies so far carried out due to the complex nature of the disease . To address this need , we carried out a single blind r and omized controlled study on the efficacy of computer cognitive rehabilitation in patients with mild cognitive decline . We here present preliminary data on 11 patients with diagnosis of Alzheimer 's Disease ( AD ) and mild cognitive decline r and omly assigned to treatment ( a ) or control ( b ) condition ( i.e. specific vs. aspecific treatment ) . The specific treatment ( a ) consisted in a cycle of 12 individual sessions of computer exercises , while the control condition ( b ) consisted in sessions of semi-structured interviews with patients , conducted with the same frequency and time period as ( a ) . Cognitive , behavioural and functional assessment was performed by an expert evaluator , blinded to the patients ' group allocation . Preliminary results show a significant performance decline only in the control group at the 9-month follow-up compared to both baseline and the 3-month follow-up . Our results suggest that computer based cognitive training in patients with AD and mild cognitive decline is effective at least in delaying the continuous progression of cognitive impairment in AD BACKGROUND Executive dysfunction is common in geriatric depression and persists after improvement of depressive symptoms . This study examined the relationship of executive impairment to the course of depressive symptoms among elderly patients with major depression . METHODS A total of 112 nondemented elderly patients with major depression participated in an 8-week citalopram trial at a target daily dose of 40 mg . Executive functions were assessed with the initiation/perseveration subscale of the Dementia Rating Scale and the Stroop Color-Word test  . Medical burden was rated with the Cumulative Illness Rating Scale . RESULTS Both abnormal initiation/perseveration and abnormal Stroop Color-Word scores were associated with an unfavorable response of geriatric depression to citalopram . In particular , initiation/perseveration scores below the median ( < or = 35 ) and Stroop scores at the lowest quartile ( < or = 22 ) predicted limited change in depressive symptoms . Impairment in other Dementia Rating Scale cognitive domains did not significantly influence the outcome of depression . CONCLUSIONS Executive dysfunction increases the risk for poor response of geriatric depression to citalopram . Because executive functions require frontostriatal-limbic integrity , this observation provides the rationale for investigation of the role of specific frontostriatal-limbic pathways in perpetuating geriatric depression . Depressed elderly patients with executive dysfunction require vigilant clinical attention because they might be at risk to fail treatment with a selective serotonin reuptake inhibiting antidepressant BACKGROUND Neuropsychological deficits in depression include difficulties with psychomotor speed , executive functions and memory . Some of these changes persist despite antidepressant treatment . While research in other areas of psychiatry has shown cognitive training techniques to be effective , only one study has evaluated this approach in depression . METHODS Sixteen patients ( mean age=33.5years ) with a lifetime diagnosis of major depressive disorder were administered a st and ardised battery of neuropsychological tests and allocated to treatment ( n=8 ) or waitlist control ( n=8 ) conditions . The treatment consisted of 10-weeks of twice weekly cognitive training using the Neuropsychological Educational Approach to Remediation . All participants were re-assessed after 10-weeks by interviewers blinded to group allocation . RESULTS Participants in the treatment condition demonstrated greater improvements on tests of memory encoding and memory retention than the waitlist control group . There were no observable benefits in terms of psychomotor speed or executive functions or in self-reported levels of disability . Affective symptoms also remained stable . LIMITATIONS This study included a small sample of participants and treatment allocation was not r and omised . CONCLUSIONS Cognitive training in affective disorders improves memory performance . It may be an effective non-pharmacological treatment option for improving cognitive functions , which in turn , may improve psychosocial functioning and reduce disability . This study supports theories suggesting cognitive training may promote neuroplasticity BACKGROUND A number of non-pharmacological methods are available to help elderly people with cognitive impairment .  Unstructured and non- evidence based interventions are commonly used . The multicomponent therapy MAKS ( a German acronym for Motor , Activities of daily living , Cognitive , Social ) has already been evaluated in nursing homes ; in this study , we investigated its use in day care centers ( DCCs ) . METHODS A cluster-r and omized , controlled , single-blinded trial involving a 6-month intervention phase was performed . 362 cognitively impaired persons in 32 DCCs took part in the trial . Multiple regression analyses were used to determine whether MAKS therapy led to any statistically significant and clinical ly relevant improvement over time ( compared to membership in the control group ) in these persons ' cognitive abilities and activities of daily living ( ADL ) abilities , as assessed , respectively , with the Mini-Mental State Examination ( MMSE ) and the Erlangen Test of Activities of Daily Living in Persons with Mild Dementia or Mild Cognitive Impairment ( ETAM ) . A primary per- protocol analysis was supplemented by an intention-to-treat analysis . Two secondary outcomes ( social behavior and neuropsychiatric symptoms ) were analyzed exploratively as well . Study registration : IS RCT N16412551 . RESULTS In the primary per- protocol analysis at 6 months , the intervention group had significantly better MMSE and ETAM scores than the control group ( Cohen 's d , 0.26 and 0.21 , respectively ; p = 0.012 for both ) . The same was found in the ITT analysis at 6 months ( Cohen 's d = 0.21 , p = 0.033 ; and Cohen 's d = 0.20 , p = 0.019 , respectively ) . Neuropsychiatric symptoms , one of the secondary outcomes , also evolved more favorably in the intervention group ( Cohen 's d = 0.23 , p = 0.055 ) . CONCLUSION MAKS therapy is effective for persons with cognitive impairment ranging from mild cognitive impairment ( MCI ) to moderate dementia who live at home and regularly visit a day care center . The fact that 32 day care facilities from all over Germany participated in this study gives its findings high external validity BACKGROUND Cognitive complaints are reported frequently after breast cancer treatments . Their association with neuropsychological ( NP ) test performance is not well-established . METHODS Early-stage , posttreatment breast cancer patients were enrolled in a prospect i ve , longitudinal , cohort study prior to starting endocrine therapy . Evaluation included an NP test battery and self-report question naires assessing symptoms , including cognitive complaints . Multivariable regression models assessed associations among cognitive complaints , mood , treatment exposures , and NP test performance . RESULTS One hundred eighty-nine breast cancer patients , aged 21 - 65 years , completed the evaluation ; 23.3 % endorsed higher memory complaints and 19.0 % reported higher executive function complaints ( > 1 SD above the mean for healthy control sample ) . Regression modeling demonstrated a statistically significant association of higher memory complaints with combined chemotherapy and radiation treatments ( P = .01 ) , poorer NP verbal memory performance ( P = .02 ) , and higher depressive symptoms ( P < .001 ) , controlling for age and IQ . For executive functioning complaints , multivariable modeling controlling for age , IQ , and other confounds demonstrated statistically significant associations with better NP visual memory performance ( P = .03 ) and higher depressive symptoms ( P < .001 ) , whereas combined chemotherapy and radiation treatment ( P = .05 ) approached statistical significance . CONCLUSIONS About one in five post-adjuvant treatment breast cancer patients had elevated memory and /or executive function complaints that were statistically significantly associated with domain-specific NP test performances and depressive symptoms ; combined chemotherapy and radiation treatment was also statistically significantly associated with memory complaints . These results and other emerging studies suggest that subjective cognitive complaints in part reflect objective NP performance , although their etiology and biology appear to be multifactorial , motivating further transdisciplinary research Background Recent research suggests that a combination of both pharmacological and psychosocial treatments targeting cognitive functions improves cognition in patients with Alzheimer ’s disease ( AD ) . The present study evaluated the effectiveness of a 1-year cognitive training ( CT ) by comparing the cognitive performance of 16 patients with AD treated with CT and cholinesterase inhibitors ( ChEIs ) ( experimental group ) with the performance of 16 patients treated with a non-specific cognitive treatment and ChEIs ( control group ) . Methods This study was a single-blind r and omized controlled trial . The patients in the experimental group received pharmacological treatment and repeated cycles of CT for 1 year , whereas the control group received pharmacological treatment and repeated cycles of non-specific cognitive exercises . The patients in the two groups were administered a variety of neuropsychological tests measuring several cognitive functions ( i.e. memory , language , reasoning , executive function , working memory and apraxia ) , activities of daily living , and depression . Results After 1 year of training , the experimental group scored significantly higher on the Mini Mental State Examination , the Milan Overall Dementia Assessment battery and in other five neuropsychological tests , compared to the control group . Conclusions Present results suggest that repeated cycles of CT in patients with AD treated with ChEIs are associated with benefits in several areas of cognitive function Cognitive dysfunction is common in older persons suffering from a major depression . However , the degree to which this dysfunction is reversible with successful treatment of the depression remains uncertain . The present study examined the effects that treatment ( r and omized double-blind design ) with either an SSRI ( paroxetine ) or a tricyclic antidepressant ( nortriptyline ) had on cognition in older depressed patients . The patients ' performance was compared to that of a group of normal controls of similar age and education . Patients and controls were administered measures of working memory , information-processing speed , episodic memory and attention five times over the course of a 12 week trial . At baseline , the patients performed more poorly than the elderly controls on all cognitive measures . While the patients ' performance did improve over the course of their treatment , the magnitude of this improvement did not exceed that produced in the elderly controls by practice alone . The same pattern of results was evident in both intent-to-treat and responder analyses . Thus , there was no evidence that the depressed patients ' cognitive performance normalized after response to antidepressant therapy . Neither the patients ' age at onset nor their baseline level of cognitive functioning influenced the amount by which their performance improved over the 12 week trial . There was no difference between paroxetine and nortriptyline in the amount of cognitive change associated with treatment . The present results suggest that cognitive dysfunction persists in older depressed patients even after their mood disorder has responded to antidepressant medications
Results show that various classes of antidepressants exert improving effects on cognitive function across several cognitive domains .
Specifically , studies suggest that SSRIs , the SSRE tianeptine , the SNRI duloxetine , vortioxetine and other antidepressants such as bupropion and moclobemide may exert certain improving effects on cognitive function in depression , such as in learning and memory and executive function .
The few non-pharmacological studies conducted employing cognitive orientated treatments and cognitive remediation therapy show promising results for the improvement of cognitive impairment in depression .
Cognitive dysfunction is of clinical significance and exerts longst and ing implication on patients ׳ function .
Pharmacological and non-pharmacological treatments of cognitive dysfunction are emerging .
This review evaluates pharmacological and non-pharmacological treatments of cognitive impairment primarily in the domains of memory , attention , processing speed and executive function in clinical depression .