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    Depressive symptoms, antidepressant use, and future cognitive health in postmenopausal women: the Women's Health Initiative Memory Study

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    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
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    UMass Chan Affiliations
    Department of Medicine, Division of Preventive and Behavioral Medicine
    Document Type
    Journal Article
    Publication Date
    2012-08-01
    Keywords
    Antidepressive Agents
    Climacteric
    Dementia
    Depressive Disorder
    Estrogen Replacement Therapy*
    Mild Cognitive Impairment
    Community Health and Preventive Medicine
    Mental and Social Health
    Preventive Medicine
    Psychiatry and Psychology
    
    Metadata
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    Link to Full Text
    http://dx.doi.org/10.1017/S1041610211002778
    Abstract
    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 site
    DOI
    10.1017/S1041610211002778
    Permanent Link to this Item
    http://hdl.handle.net/20.500.14038/44811
    PubMed ID
    22301077
    Related Resources
    Link to Article in PubMed
    ae974a485f413a2113503eed53cd6c53
    10.1017/S1041610211002778
    Scopus Count
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    Population and Quantitative Health Sciences Publications

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