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The purpose of this study was to examine the relationships between depression and cognitive functions in vascular dementia, and to find out the lesion sites in the brain that increase the risk of depression. Comprehensive cognitive functions were assessed by the Seoul Neuropsychological Screening Battery and several executive function tests. Depression was assessed using the Geriatric Depression Scale, the Cornell Scale for Depression in Dementia, and the DSM-IV criteria. The subjects were 35 patients of vascular dementia in the early stage (CDR 0.5~1) and 35 normal elderly. There was no significant difference in the demographic variables. The results showed that the vascular dementia group had significantly higher depressive levels than the normal elderly, and that depression was negatively correlated with frontal/executive function, attention, psychomotor speed, and verbal memory. The hierarchical multiple regression analyses showed that depression significantly predicted the phonemic fluency. This result suggests that there is a close connection between the left frontal lobe and depression. Based on this result, the vascular dementia patients were divided into two subgroups, the left frontal group that had lesions in the left frontal lobe and the others that had lesions in other areas besides the left frontal lobe. It was found that only the left frontal group had higher depressive levels than the normal elderly. The logistic regression analysis showed that the left frontal group had an odds ratio of 6.44 for the increased risk of developing depression compared with the normal elderly.
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