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No. 4 (2025)

ORIRGINAL RESEARCH

Cognitive Vulnerability in the Elderly Patients with Depression: Who is at Risk?

https://doi.org/10.48612/psyph/txgg-u7bv-mb26

Published 2025-12-30

  • T.P. Safarova
    • ,
  • I.V. Kolykhalov

T.P. Safarova
Mental Health Research Center

I.V. Kolykhalov
Mental Health Research Center; Russian Medical Academy of Continuous Professional Education

Abstract

Background. Depression among the elderly is one of the main causes of global disability and a decline in the quality of life. Late-life depressions often accompany cognitive impairments, which can persist after the end of the depressive phase. The identification of clinico-biological predictors of the development and progression of cognitive disorders is an urgent problem of modern research.

Objective — to study the influence of clinical and biological characteristics of patients with late-onset depression on cognitive functioning (clinical and follow-up study).

Material and methods. 51 patients aged 60 years and older with late-life depression who were treated in a gerontopsychiatric hospital were re-examined after 1 and 3 years. By the end of the inpatient treatment period, two groups of patients were identified: group 1 — without cognitive impairment in the structure of depression — 38 participants (74.5 %) and group 2 — 13 participants (25.5 %) — with subjective complaints of memory impairment. Subsequently, a comparative prospective follow-up of patients from the selected groups was carried out. The examination was conducted using clinical-psychopathological, psychometric, immunological and statistical methods and clinical follow-up.

Results. Patients with cognitive impairment (group 2), compared with group 1, differed in age at the time of examination (73.4 ± 7.7 and 67.8 ± 5.9 years, respectively, p < 0.05), the psychopathological structure of depression (depression with predominant negative affectivity occurred in 76.9 and 55.3 % of cases, respectively, p < 0.05), the burden of multiple comorbidities, including cardiac pathology (100 and 76.3 % of cases, respectively, p < 0.05), lower efficacy of therapy (p < 0.001). In addition, the compared groups differed in immunological characteristics: all patients with complaints of memory impairment belonged to immunophenotype 2 (with reduced activity of leukocyte elastase and its protease inhibitor).

Conclusion. The study revealed a high risk of cognitive impairment in elderly patients with depression, which was associated with certain clinical and biological characteristics. The study revealed the following predictors of cognitive decline: the older age of patients, the predominance of negative affectivity in the structure of depression, multiple comorbidities, incomplete remissions, and features of the immune status.

Keywords

depression, cognitive functioning, clinical and biological features, older age, predictors of cognitive decline

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