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

Alaise Silva Santos Siqueira, Marina Maria Biella, Marcus Kiiti Borges, Sivan Mauer, Daniel Apolinario, Tania Correa de Toledo Ferraz Alves, Wilson Jacob-Filho, Richard C. Oude Voshaar, Ivan Aprahamian*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review


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.

Original languageEnglish
Number of pages7
Publication statusE-pub ahead of print - 5-Jul-2021


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

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