Executive Functioning in Late-Life Depression

Abstract

Executive functions are control mechanisms that regulate aspects of cognition and emotion. Impairments in executive functioning are prominent following disruption to frontolimbic connections involved in mood regulation. Executive dysfunction is common in older adults with major depression and is associated with poor course of illness and worse clinical outcome. Thus, elderly depressed patients with executive functioning impairment require careful treatment planning and close follow-up. This review aims to provide the clinician with a practical understanding of executive dysfunction in older adults with major depression. To this end, it provides an introduction to the neurobiology and clinical manifestations of executive dysfunction in late-life depression. Special attention is given to current assessment practices that can be used to enhance clinical evaluation and treatment planning.