Antidepressant Use and Dementia Risk in the Elderly
Use of potentially inappropriate antidepressants was associated with an increased risk for depression after adjustment for age, sex, and education level.
Antidepressants categorized as potentially inappropriate medication for elderly patients were shown to be associated with an increased risk of dementia, according to the results of a study published in the Journal of Affective Disorders.
Using data from a prospective cohort study, German researchers followed 3239 nondemented patients older than 75 (mean age 79.62) for up to 12 years over 8 primary care visits. They then evaluated the association between antidepressant intake and subsequent depression.
Overall, antidepressant intake was associated with an increased risk for depression after adjustment for age, sex, and education level (hazard ratio [HR] 1.53, 95% CI: 1.16-2.02; P =.003).
After adjustment for age, sex, education, and depressive symptoms, the increase in dementia risk was only observed for antidepressants considered to be potentially inappropriate according to the German Priscus list (HR 1.49, 95% CI: 1.06-2.10; P =.021) but not for other antidepressants (HR 1.04, 95% CI: 0.66-1.66; P =.863).
After controlling for baseline global cognition, the researchers did not observe an association between antidepressants categorized as potentially inappropriate medications and subsequent dementia. They suggested that this may be due to long-term intake of the potentially inappropriate medications prior to the study, but they did not conduct an analysis of the duration of antidepressant use.
The researchers concluded that "not antidepressants per se, but only [potentially inappropriate] antidepressant drugs were associated with an increased risk for subsequent all-cause dementia… Our results can provide valuable information for health services and physicians who prescribe antidepressant drugs to elderly and very old patients."
Heser K, Luck T, Röhr S, et al; for the AgeCoDe & AgeQualiDe Study Groups. Potentially inappropriate medication: association between the use of antidepressant drugs and the subsequent risk for dementia [published online September 14, 2017]. J Affect Disord. doi:10.1016/j.jad.2017.09.016