Decision-making executive function profile and performance in older adults with major depression: a case-control study

Abstract

Objectives

Decision making (DM) is a component of executive functioning, essential for choosing appropriate decisions. Executive dysfunctioning is particularly common in late-life depression, however the literature is scarce on DM. This case-control study aimed to evaluate the DM profile and performance in participants with and without unipolar major depression.

Method

The DM profile and performance were assessed by the Melbourne Decision Making Questionnaire and the Iowa Gambling Task (IGT), respectively, in three groups of older adults from a university-based geriatric psychiatry clinic, i.e. current depression (n = 30), remitted depression (n = 43) and healthy controls (n = 59). The Hamilton Depression scale (HAM-D) 21 items, the Hamilton Anxiety scale, and the Mini-Mental State Examination were used to access depressive symptoms, anxiety symptoms, and cognitive impairment, respectively. Multinomial, nominal and binary logistic regression was used to evaluate the associations between depression, depressive symptomatology and DM.

Results

In comparison to the control group, patients with current depression presented higher scores in buck-passing and proscratination DM profiles. In the hypervigilance profile, there was a significant difference between current and remitted depression groups. A higher value ​in the HAM-D scale increased the probability of disadvantageous DM profiles. Depressive patients showed a tendency of a higher mean score in both disadvantageous decks (A and B) of IGT. Patients with current depression showed a worse performance compared to the remitted depression group in the IGT netscore.

Conclusion

Older adults with current depression showed DM profiles considered maladaptive or disadvantageous compared to both remitted depression and healthy controls groups.

Keywords:

• Decision-making
• executive function
• cognitive impairment
• major depression
• older adults

Disclosure statement

The authors report no conflict of interest.

Data availability statement

Data is available upon request to the corresponding author.

Ethics approval statement

Local ethics committee approved the study.

Patient consent statement

All participants have signed a consent form.

Additional information

Funding

Ivan Aprahamian has a national public grant level two (304069/2017-5) from the National Council for Scientific and Technological Development (Ministry of Science, Technology, Innovation and Communications, Brazil). Alaise Silva Santos de Siqueira receive financial support from the government agency Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES).