Depressive symptoms, antidepressant use, and future cognitive health in postmenopausal women: the Women's Health Initiative Memory Study
Authors
Goveas, Joseph S.Hogan, Patricia E.
Kotchen, Jane Morley
Smoller, Jordan W.
Denburg, Natalie L.
Manson, JoAnn E.
Tummala, Aruna
Mysiw, W. Jerry
Ockene, Judith K.
Woods, Nancy F.
Espeland, Mark A.
Wassertheil-Smoller, Sylvia
UMass Chan Affiliations
Department of Medicine, Division of Preventive and Behavioral MedicineDocument Type
Journal ArticlePublication Date
2012-08-01Keywords
Antidepressive AgentsClimacteric
Dementia
Depressive Disorder
Estrogen Replacement Therapy*
Mild Cognitive Impairment
Community Health and Preventive Medicine
Mental and Social Health
Preventive Medicine
Psychiatry and Psychology
Metadata
Show full item recordAbstract
BACKGROUND: Antidepressants are commonly prescribed medications in the elderly, but their relationship with incident mild cognitive impairment (MCI) and probable dementia is unknown. METHODS: The study cohort included 6,998 cognitively healthy, postmenopausal women, aged 65-79 years, who were enrolled in a hormone therapy clinical trial and had baseline depressive symptoms and antidepressant use history assessments at enrollment, and at least one postbaseline cognitive measurement. Participants were followed annually and the follow-up averaged 7.5 years for MCI and probable dementia outcomes. A central adjudication committee classified the presence of MCI and probable dementia based on extensive neuropsychiatric examination. RESULTS: Three hundred and eighty-three (5%) women were on antidepressants at baseline. Antidepressant use was associated with a 70% increased risk of MCI, after controlling for potential covariates including the degree of depressive symptom severity. Selective serotonin reuptake inhibitors (SSRIs) and tricyclic antidepressants (TCAs) were both associated with MCI (SSRIs: hazard ratios (HR), 1.78 [95% CI, 1.01-3.13]; TCAs: HR, 1.78 [95% CI, 0.99-3.21]). Depressed users (HR, 2.44 [95% CI, 1.24-4.80]), non-depressed users (HR, 1.79 [95% CI, 1.13-2.85]), and depressed non-users (HR, 1.62 [95% CI, 1.13-2.32]) had increased risk of incident MCI. Similarly, all three groups had increased risk of either MCI or dementia, relative to the control cohort. CONCLUSIONS: Antidepressant use and different levels of depression severity were associated with subsequent cognitive impairment in a large cohort of postmenopausal women. Future research should examine the role of antidepressants in the depression-dementia relationship and determine if antidepressants can prevent incident MCI and dementia in individuals with late-life depression subtypes with different levels of severity.Source
Int Psychogeriatr. 2012 Aug;24(8):1252-64. Epub 2012 Feb 3. Link to article on publisher's siteDOI
10.1017/S1041610211002778Permanent Link to this Item
http://hdl.handle.net/20.500.14038/44811PubMed ID
22301077Related Resources
Link to Article in PubMedae974a485f413a2113503eed53cd6c53
10.1017/S1041610211002778