@article {8287, title = {Antidepressant Use and Cognitive Decline: The Health and Retirement Study.}, journal = {Am J Med}, volume = {128}, year = {2015}, month = {2015 Jul}, pages = {739-46}, publisher = {128}, 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.

}, keywords = {Age 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}, issn = {1555-7162}, doi = {10.1016/j.amjmed.2015.01.007}, author = {Jane S Saczynski and Allison B Rosen and Ryan J McCammon and Zivin, Kara and Susan E. Andrade and Kenneth M. Langa and Sandeep Vijan and Paul A Pirraglia and Becky A. Briesacher} } @article {7911, title = {Trends in depressive symptom burden among older adults in the United States from 1998 to 2008.}, journal = {J Gen Intern Med}, volume = {28}, year = {2013}, month = {2013 Dec}, pages = {1611-9}, publisher = {28}, abstract = {

CONTEXT: Diagnosis and treatment of depression has increased over the past decade in the United States. Whether self-reported depressive symptoms among older adults have concomitantly declined is unknown.

OBJECTIVE: To examine trends in depressive symptoms among older adults in the US between 1998 and 2008.

DESIGN: Serial cross-sectional analysis of six biennial assessments.

SETTING: Health and Retirement Study (HRS), a nationally-representative survey. PATIENTS OR OTHER PARTICIPANTS Adults aged 55 and older (N = 16,184 in 1998).

MAIN OUTCOME MEASURE: The eight-item Center for Epidemiologic Studies Depression scale (CES-D8) assessed three levels of depressive symptoms (none = 0, elevated = 4+, severe = 6+), adjusting for demographic and clinical characteristics.

RESULTS: Having no depressive symptoms increased over the 10-year period from 40.9~\% to 47.4~\% (prevalence ratio [PR]: 1.16, 95 \% CI: 1.13-1.19), with significant increases in those aged >= 60 relative to those aged 55-59. There was a 7~\% prevalence reduction of elevated symptoms from 15.5~\% to 14.2~\% (PR: 0.93, 95 \% CI: 0.88-0.98), which was most pronounced among those aged 80-84 in whom the prevalence of elevated symptoms declined from 14.3~\% to 9.6~\%. Prevalence of having severe depressive symptoms increased from 5.8~\% to 6.8~\% (PR: 1.17, 95 \% CI: 1.06-1.28); however, this increase was limited to those aged 55-59, with the probability of severe symptoms increasing from 8.7~\% to 11.8~\%. No significant changes in severe symptoms were observed for those aged >= 60.

CONCLUSIONS: Overall late-life depressive symptom burden declined significantly from 1998 to 2008. This decrease appeared to be driven primarily by greater reductions in depressive symptoms in the oldest-old, and by an increase in those with no depressive symptoms. These changes in symptom burden were robust to physical, functional, demographic, and economic factors. Future research should examine whether this decrease in depressive symptoms is associated with improved treatment outcomes, and if there have been changes in the treatment received for the various age cohorts.

}, keywords = {Age Factors, Aged, Aged, 80 and over, Cohort Studies, Cost of Illness, Cross-Sectional Studies, depression, Female, Humans, Male, Middle Aged, United States}, issn = {1525-1497}, doi = {10.1007/s11606-013-2533-y}, author = {Zivin, Kara and Paul A Pirraglia and Ryan J McCammon and Kenneth M. Langa and Sandeep Vijan} }