Antidepressant Use and Cognitive Decline: The Health and Retirement Study.

TitleAntidepressant Use and Cognitive Decline: The Health and Retirement Study.
Publication TypeJournal Article
Year of Publication2015
AuthorsSaczynski, JS, Rosen, AB, McCammon, RJ, Zivin, K, Andrade, SE, Langa, KM, Vijan, S, Pirraglia, PA, Briesacher, BA
JournalAm J Med
Volume128
Issue7
Pagination739-46
Date Published2015 Jul
ISSN Number1555-7162
KeywordsAge Distribution, Aged, Aged, 80 and over, Antidepressive Agents, Cognition, Cross-Sectional Studies, Depressive Disorder, Female, Follow-Up Studies, Geriatric Assessment, Humans, Incidence, Male, Middle Aged, Reference Values, Risk Assessment, Sex Distribution, Surveys and Questionnaires, United States
Abstract

BACKGROUND: Depression is associated with cognitive impairment and dementia, but whether treatment for depression with antidepressants reduces the risk for cognitive decline is unclear. We assessed the association between antidepressant use and cognitive decline over 6 years.

METHODS: Participants were 3714 adults aged 50 years or more who were enrolled in the nationally representative Health and Retirement Study and had self-reported antidepressant use. Depressive symptoms were assessed using the 8-item Center for Epidemiologic Studies Depression Scale. Cognitive function was assessed at 4 time points (2004, 2006, 2008, 2010) using a validated 27-point scale. Change in cognitive function over the 6-year follow-up period was examined using linear growth models, adjusted for demographics, depressive symptoms, comorbidities, functional limitations, and antidepressant anticholinergic activity load.

RESULTS: At baseline, cognitive function did not differ significantly between the 445 (12.1%) participants taking antidepressants and those not taking antidepressants (mean, 14.9%; 95% confidence interval, 14.3-15.4 vs mean, 15.1%; 95% confidence interval, 14.9-15.3). During the 6-year follow up period, cognition declined in both users and nonusers of antidepressants, ranging from -1.4 change in mean score in those with high depressive symptoms and taking antidepressants to -0.5 change in mean score in those with high depressive symptoms and not taking antidepressants. In adjusted models, cognition declined in people taking antidepressants at the same rate as those not taking antidepressants. Results remained consistent across different levels of baseline cognitive function, age, and duration of antidepressant use (prolonged vs short-term).

CONCLUSIONS: Antidepressant use did not modify the course of 6-year cognitive change in this nationally representative sample.

DOI10.1016/j.amjmed.2015.01.007
User Guide Notes

http://www.ncbi.nlm.nih.gov/pubmed/25644319?dopt=Abstract

Endnote Keywords

Antidepressants/Cognition/Depression/CES Depression Scale/CES Depression Scale/COMORBIDITY/Depressive Symptoms

Endnote ID

999999

Alternate JournalAm. J. Med.
Citation Key8287
PubMed ID25644319
PubMed Central IDPMC4618694
Grant ListU01 AG009740 / AG / NIA NIH HHS / United States
K01AG33643 / AG / NIA NIH HHS / United States
P30 AG024824 / AG / NIA NIH HHS / United States
P01 AG031098 / AG / NIA NIH HHS / United States
K01 AG033643 / AG / NIA NIH HHS / United States
U01 HL105268 / HL / NHLBI NIH HHS / United States
U01 AG09740 / AG / NIA NIH HHS / United States
U01HL105268 / HL / NHLBI NIH HHS / United States
P01AG031098 / AG / NIA NIH HHS / United States