%0 Journal Article %J Am J Med %D 2015 %T Antidepressant Use and Cognitive Decline: The Health and Retirement Study. %A Jane S Saczynski %A Allison B Rosen %A Ryan J McCammon %A Zivin, Kara %A Susan E. Andrade %A Kenneth M. Langa %A Sandeep Vijan %A Paul A Pirraglia %A Becky A. Briesacher %K Age Distribution %K Aged %K Aged, 80 and over %K Antidepressive Agents %K Cognition %K Cross-Sectional Studies %K Depressive Disorder %K Female %K Follow-Up Studies %K Geriatric Assessment %K Humans %K Incidence %K Male %K Middle Aged %K Reference Values %K Risk Assessment %K Sex Distribution %K Surveys and Questionnaires %K United States %X

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.

%B Am J Med %I 128 %V 128 %P 739-46 %8 2015 Jul %G eng %N 7 %1 http://www.ncbi.nlm.nih.gov/pubmed/25644319?dopt=Abstract %2 PMC4618694 %4 Antidepressants/Cognition/Depression/CES Depression Scale/CES Depression Scale/COMORBIDITY/Depressive Symptoms %$ 999999 %R 10.1016/j.amjmed.2015.01.007 %0 Journal Article %J J Gen Intern Med %D 2013 %T Trends in depressive symptom burden among older adults in the United States from 1998 to 2008. %A Zivin, Kara %A Paul A Pirraglia %A Ryan J McCammon %A Kenneth M. Langa %A Sandeep Vijan %K Age Factors %K Aged %K Aged, 80 and over %K Cohort Studies %K Cost of Illness %K Cross-Sectional Studies %K depression %K Female %K Humans %K Male %K Middle Aged %K United States %X

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.

%B J Gen Intern Med %I 28 %V 28 %P 1611-9 %8 2013 Dec %G eng %N 12 %1 http://www.ncbi.nlm.nih.gov/pubmed/23835787?dopt=Abstract %2 PMC3832736 %4 Depression/Risk-Factors/Retirement/Older Adults/Depressive Symptoms %$ 69364 %R 10.1007/s11606-013-2533-y %0 Journal Article %J Am J Geriatr Psychiatry %D 2010 %T Depression among older adults in the United States and England. %A Zivin, Kara %A David J Llewellyn %A Iain A Lang %A Sandeep Vijan %A Mohammed U Kabeto %A Erin M Miller %A Kenneth M. Langa %K Aged %K Aged, 80 and over %K depression %K England %K Female %K Health Behavior %K Health Status %K Health Surveys %K Humans %K Male %K Prevalence %K Risk Factors %K United States %K White People %X

CONTEXT: Depression negatively affects health and well being among older adults, but there have been no nationally representative comparisons of depression prevalence among older adults in England and the United States.

OBJECTIVE: The authors sought to compare depressive symptoms among older adults in these countries and identify sociodemographic and clinical correlates of depression in these countries.

DESIGN AND SETTING: The authors assessed depressive symptoms in non-Hispanic whites aged 65 years and older in 2002 in two nationally representative, population-based studies: the U.S. Health and Retirement Study and English Longitudinal Study of Ageing.

PARTICIPANTS: A total of 8,295 Health and Retirement Study respondents and 5,208 English Longitudinal Study of Ageing respondents.

MAIN OUTCOME MEASURES: The authors measured depressive symptoms using the eight-item Center for Epidemiologic Studies Depression Scale. The authors determined whether depressive symptom differences between the United States and England were associated with sociodemographic characteristics, chronic health conditions, and health behaviors.

RESULTS: Significant depressive symptoms (Center for Epidemiologic Studies Depression Scale score ≥4) were more prevalent in English than U.S. adults (17.6% versus 14.6%, adjusted Wald test F([1, 1593]) = 11.4, p < 0.001). Adjusted rates of depressive symptoms in England were 19% higher compared with the United States (odds ratio: 1.19, 95% confidence interval: 1.01-1.40). U.S. adults had higher levels of education, and net worth, but lower levels of activities of daily living/instrumental activities of daily living impairments, tobacco use, and cognitive impairment, which may have contributed to relatively lower levels of depressive symptoms in the United States.

CONCLUSIONS: Older adults in the United States had lower rates of depressive symptoms than their English counterparts despite having more chronic health conditions. Future cross-national studies should identify how depression treatment influences outcomes in these populations.

%B Am J Geriatr Psychiatry %I 11 %V 18 %P 1036-44 %8 2010 Nov %G eng %N 11 %1 http://www.ncbi.nlm.nih.gov/pubmed/20808088?dopt=Abstract %2 PMC3786867 %4 Aged, 80 and over/Depression/Health Behavior/Health Status/Health Surveys/Prevalence/Risk Factors/epidemiology %$ 25240 %R 10.1097/JGP.0b013e3181dba6d2 %0 Report %D 2003 %T The Impact of Poor Health Behaviors on Workforce Disability %A Richardson, Caroline R. %A Jennifer T. Hanlon %A Hillary J. Mull %A Sandeep Vijan %A Rodney A. Hayward %A Linda A. Wray %A Kenneth M. Langa %K Disabilities %K Health Behavior %K Labor force participation %K Older Adults %X The effects of poor health habits on mortality have been studied extensively. However, few studies have examined the impact of these health behaviors on workforce disability. In the Health and Retirement Study, a nationally representative cohort of 6044 Americans who were between the ages of 51 and 61 and who were working in 1992, we found that both baseline smoking status and a sedentary lifestyle predict workforce disability six years later. If this relationship is causal, cost-benefit analyses of health behavior intervention that neglect workforce disability may substantially underestimate the benefits of such interventions. %I University of Michigan Retirement Research Center %C Ann Arbor %P 1-22 %8 06/2003 %G eng %U https://core.ac.uk/download/pdf/7189096.pdf