The association of antidepressant drug usage with cognitive impairment or dementia, including Alzheimer disease: A systematic review and meta-analysis
- PMID:28029715
- PMCID: PMC5347943
- DOI: 10.1002/da.22584
The association of antidepressant drug usage with cognitive impairment or dementia, including Alzheimer disease: A systematic review and meta-analysis
Abstract
Objective: To determine if antidepressant drug usage is associated with cognitive impairment or dementia, including Alzheimer disease (AD).
Method: We conducted a systematic search of Medline, PubMed, PsycINFO, Web of Science, Embase, CINAHL, and the Cochrane Library. An initial screen by abstracts and titles was performed, and relevant full articles were then reviewed and assessed for their methodologic quality. Crude effect estimates were extracted from the included articles and a pooled estimate was obtained using a random effects model.
Results: Five articles were selected from an initial pool of 4,123 articles. Use of antidepressant drugs was associated with a significant twofold increase in the odds of some form of cognitive impairment or dementia (OR = 2.17). Age was identified as a likely modifier of the association between antidepressant use and some form of cognitive impairment or AD/dementia. Studies that included participants with an average age equal to or greater than 65 years showed an increased odds of some form of cognitive impairment with antidepressant drug usage (OR = 1.65), whereas those with participants less than age 65 revealed an even stronger association (OR = 3.25).
Conclusions: Antidepressant drug usage is associated with AD/dementia and this is particularly evident if usage begins before age 65. This association may arise due to confounding by depression or depression severity. However, biological mechanisms potentially linking antidepressant exposure to dementia have been described, so an etiological effect of antidepressants is possible. With this confirmation that an association exists, clarification of underlying etiologic pathways requires urgent attention.
Keywords: antidepressants; cognition; depression; geriatric/aging/elderly; pharmacoepidemiology.
© 2016 The Authors. Depression and Anxiety published by Wiley Periodicals, Inc.
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References
- Aguero‐Torres, H. , Fratiglioni, L. , Guo, Z. , Viitanen, M. , & Winblad, B. (1998). Prognostic factors in very old demented adults: A seven‐year follow‐up from a population‐based survey in Stockholm. Journal of the American Geriatrics Society, 46, 444–452. - PubMed
- Almeida, N. D. , Basso, O. , Abrahamowicz, M. , Gagnon, R. , & Tamblyn, R. (2016). Risk of miscarriage in women receiving antidepressants in early pregnancy, correcting for induced abortions. Epidemiology, 27, 538–546. - PubMed
- Angst, J. , Gamma, A. , Gerber‐Werder, R. , Zarate, C. A.,Jr. , & Manji, H. K. (2007). Does long‐term medication with lithium, clozapine or antidepressants prevent or attenuate dementia in bipolar and depressed patients? International Journal of Psychiatry in Clinical Practice, 11, 2–8. - PubMed
- Ardal, G. , & Hammar, A. (2011). Is impairment in cognitive inhibition in the acute phase of major depression irreversible? Results from a 10‐year follow‐up study. Psychology and Psychotherapy, 84, 141–150. - PubMed
- Bachman, D. L. , Wolf, P. A. , Linn, R. T. , Knoefel, J. E. , Cobb, J. L. , Belanger, A. J. , . . . D'Agostino, R. B. (1993). Incidence of dementia and probable Alzheimer's disease in a general population: The Framingham Study. Neurology, 43, 515–519. - PubMed
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