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BMC Med. 2017 Apr 19;15(1):81. doi: 10.1186/s12916-017-0847-z.

Antidepressant use and cognitive decline in community-dwelling elderly people - The Three-City Cohort.

Author information

1
Inserm U1061, Neuropsychiatry: epidemiological and clinical research, 39 avenue Charles Flahault, BP 34493, 34093, Montpellier cedex 05, France. isabelle.carriere@inserm.fr.
2
Univ. Montpellier, U1061, Montpellier, France. isabelle.carriere@inserm.fr.
3
Inserm U1061, Neuropsychiatry: epidemiological and clinical research, 39 avenue Charles Flahault, BP 34493, 34093, Montpellier cedex 05, France.
4
Univ. Montpellier, U1061, Montpellier, France.
5
Department of Psychiatry, CHU Caremeau, Nîmes, France.
6
Univ. Bordeaux, Inserm, Bordeaux Population Health Research Center, UMR1219, F-33000, Bordeaux, France.
7
Department of Clinical Pharmacology, CHU Bordeaux, Bordeaux, France.
8
Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK.

Abstract

BACKGROUND:

Cognitive impairment is very common in late-life depression, principally affecting executive skills and information processing speed. The aim of the study was to examine the effect of antidepressant treatment on cognitive performances over a 10-year period.

METHODS:

The community-based cohort included 7381 participants aged 65 years and above. Five cognitive domains (verbal fluency, psychomotor speed, executive function, visuospatial skills and global cognition) were assessed up to five times over 10 years of follow-up. Treatment groups included participants under a specific antidepressant class at both baseline and the first follow-up and their follow-up cognitive data were considered until the last consecutive follow-up with a report of antidepressant use of the same class. Linear mixed models were used to compare baseline cognitive performance and cognitive decline over time according to antidepressant treatment. The models were adjusted for multiple confounders including residual depressive symptoms assessed by the Center for Epidemiologic Studies-Depression scale.

RESULTS:

At baseline, 4.0% of participants were taking antidepressants. Compared to non-users, tricyclic antidepressant users had lower baseline performances in verbal fluency, visual memory and psychomotor speed, and selective serotonin reuptake inhibitor users in verbal fluency and psychomotor speed. For the two other cognitive abilities, executive function and global cognition, no significant differences were found at baseline irrespective of the antidepressant class. Regarding changes over time, no significant differences were observed in comparison with non-users whatever the cognitive domain, except for a slight additional improvement over the follow-up in verbal fluency skills for tricyclic antidepressant users.

CONCLUSIONS:

In this large elderly general population cohort, we found no evidence for an association between antidepressant use and post-treatment cognitive decline over 10 years of follow-up in various cognitive domains.

KEYWORDS:

Antidepressants; Cognition; Cohort study; Elderly people

PMID:
28424070
PMCID:
PMC5397783
DOI:
10.1186/s12916-017-0847-z
[Indexed for MEDLINE]
Free PMC Article

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