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BMC Medicine
Published in: BMC Medicine 1/2017

Open Access 01-12-2017 | Research article

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

Authors: Isabelle Carrière, Joanna Norton, Amandine Farré, Marilyn Wyart, Christophe Tzourio, Pernelle Noize, Karine Pérès, Annie Fourrier-Réglat, Karen Ritchie, Marie Laure Ancelin

Published in: BMC Medicine | Issue 1/2017

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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.
Appendix
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Literature
1.
2.
Carriere I, Gutierrez LA, Peres K, Berr C, Barberger-Gateau P, Ritchie K, Ancelin ML. Late life depression and incident activity limitations: influence of gender and symptom severity. J Affect Disord. 2011;133(1-2):42–50.CrossRefPubMed
3.
Ryan J, Carriere I, Ritchie K, Stewart R, Toulemonde G, Dartigues JF, Tzourio C, Ancelin ML. Late-life depression and mortality: influence of gender and antidepressant use. Br J Psychiatry. 2008;192(1):12–8.CrossRefPubMed
4.
Carriere I, Farre A, Proust-Lima C, Ryan J, Ancelin ML, Ritchie K. Chronic and remitting trajectories of depressive symptoms in the elderly. Characterisation and risk factors. Epidemiol Psychiatr Sci. 2017;26(2):146–56.CrossRefPubMed
5.
Meeks TW, Vahia IV, Lavretsky H, Kulkarni G, Jeste DV. A tune in "a minor" can "b major": a review of epidemiology, illness course, and public health implications of subthreshold depression in older adults. J Affect Disord. 2011;129(1-3):126–42.CrossRefPubMedPubMedCentral
6.
7.
Wang S, Blazer DG. Depression and cognition in the elderly. Annu Rev Clin Psychol. 2015;11:331–60.CrossRefPubMed
8.
Weisenbach SL, Boore LA, Kales HC. Depression and cognitive impairment in older adults. Curr Psychiatry Rep. 2012;14(4):280–8.CrossRefPubMed
9.
Crocco EA, Castro K, Loewenstein DA. How late-life depression affects cognition: neural mechanisms. Curr Psychiatry Rep. 2010;12(1):34–8.CrossRefPubMed
10.
McDermott LM, Ebmeier KP. A meta-analysis of depression severity and cognitive function. J Affect Disord. 2009;119(1-3):1–8.CrossRefPubMed
11.
Morimoto SS, Alexopoulos GS. Cognitive deficits in geriatric depression: clinical correlates and implications for current and future treatment. Psychiatr Clin North Am. 2013;36(4):517–31.CrossRefPubMed
12.
Pimontel MA, Culang-Reinlieb ME, Morimoto SS, Sneed JR. Executive dysfunction and treatment response in late-life depression. Int J Geriatr Psychiatry. 2012;27(9):893–9.CrossRefPubMed
13.
Cipriani A, Furukawa TA, Salanti G, Geddes JR, Higgins JP, Churchill R, Watanabe N, Nakagawa A, Omori IM, McGuire H, et al. Comparative efficacy and acceptability of 12 new-generation antidepressants: a multiple-treatments meta-analysis. Lancet. 2009;373(9665):746–58.CrossRefPubMed
14.
Kirsch I, Deacon BJ, Huedo-Medina TB, Scoboria A, Moore TJ, Johnson BT. Initial severity and antidepressant benefits: a meta-analysis of data submitted to the Food and Drug Administration. PLoS Med. 2008;5(2), e45.CrossRefPubMedPubMedCentral
15.
Culang ME, Sneed JR, Keilp JG, Rutherford BR, Pelton GH, Devanand DP, Roose SP. Change in cognitive functioning following acute antidepressant treatment in late-life depression. Am J Geriatr Psychiatry. 2009;17(10):881–8.CrossRefPubMedPubMedCentral
16.
Keefe RS, McClintock SM, Roth RM, Doraiswamy PM, Tiger S, Madhoo M. Cognitive effects of pharmacotherapy for major depressive disorder: a systematic review. J Clin Psychiatry. 2014;75(8):864–76.CrossRefPubMed
17.
Goveas JS, Hogan PE, Kotchen JM, Smoller JW, Denburg NL, Manson JE, Tummala A, Mysiw WJ, Ockene JK, Woods NF, et al. Depressive symptoms, antidepressant use, and future cognitive health in postmenopausal women: the Women's Health Initiative Memory Study. Int Psychogeriatr. 2012;24(8):1252–64.CrossRefPubMed
18.
Saczynski JS, Rosen AB, McCammon RJ, Zivin K, Andrade SE, Langa KM, Vijan S, Pirraglia PA, Briesacher BA. Antidepressant use and cognitive decline: The Health and Retirement Study. Am J Med. 2015;128(7):739–46.CrossRefPubMedPubMedCentral
19.
Rabenda V, Nicolet D, Beaudart C, Bruyere O, Reginster JY. Relationship between use of antidepressants and risk of fractures: a meta-analysis. Osteoporos Int. 2013;24(1):121–37.CrossRefPubMed
20.
The 3C Study Group. Vascular factors and risk of dementia: design of the three city study and baseline characteristics of the study population. Neuroepidemiology. 2003;22(6):316–25.CrossRef
21.
Isaacs B, Kennie AT. The set test as an aid to the detection of dementia in old people. Br J Psychiatry. 1973;123(575):467–70.CrossRefPubMed
22.
Benton A. Manuel pour l'application du test de rétention visuelle. Applications cliniques et expérimentales. Paris: Centre de Psychologie Appliquée; 1965.
23.
Reitan R. Validity of the Trail Making Test as an indicator of organic brain damage. Percept Mot Skills. 1965;8:271–6.CrossRef
24.
Folstein MF, Folstein SE, McHugh PR. “Mini-mental state”. A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res. 1975;12(3):189–98.CrossRefPubMed
25.
Noize P, Bazin F, Dufouil C, Lechevallier-Michel N, Ancelin ML, Dartigues JF, Tzourio C, Moore N, Fourrier-Reglat A. Comparison of health insurance claims and patient interviews in assessing drug use: data from the Three-City (3C) Study. Pharmacoepidemiol Drug Saf. 2009;18(4):310–9.CrossRefPubMed
26.
Noize P, Bazin F, Pariente A, Dufouil C, Ancelin ML, Helmer C, Moore N, Fourrier-Reglat A. Validity of chronic drug exposure presumed from repeated patient interviews varied according to drug class. J Clin Epidemiol. 2012;65(10):1061–8.CrossRefPubMed
27.
Carriere I, Fourrier-Reglat A, Dartigues JF, Rouaud O, Pasquier F, Ritchie K, Ancelin ML. Drugs with anticholinergic properties, cognitive decline, and dementia in an elderly general population: the 3-city study. Arch Intern Med. 2009;169(14):1317–24.CrossRefPubMedPubMedCentral
28.
Ritchie K, Carriere I, de Mendonca A, Portet F, Dartigues JF, Rouaud O, Barberger-Gateau P, Ancelin ML. The neuroprotective effects of caffeine: a prospective population study (the Three City Study). Neurology. 2007;69(6):536–45.CrossRefPubMed
29.
Barberger-Gateau P, Rainville C, Letenneur L, Dartigues JF. A hierarchical model of domains of disablement in the elderly: a longitudinal approach. Disabil Rehabil. 2000;22(7):308–17.CrossRefPubMed
30.
Rosow I, Breslau N. A Guttman health scale for the aged. J Gerontol B Psychol Sci Soc Sci. 1966;21(4):556–9.
31.
Lawton MP, Brody EM. Assessment of older people: self-maintaining and instrumental activities of daily living. Gerontologist. 1969;9(3):179–86.CrossRefPubMed
32.
Katz S, Downs TD, Cash HR, Grotz RC. Progress in development of the index of ADL. Gerontologist. 1970;10(1):20–30.CrossRefPubMed
33.
Radloff L. The CES–D scale: a self-report depression scale for research in the general population. Applied Pyschological Measurement. 1977;1:385–401.CrossRef
34.
Sheehan DV, Lecrubier Y, Sheehan KH, Amorim P, Janavs J, Weiller E, Hergueta T, Baker R, Dunbar GC. The Mini-International Neuropsychiatric Interview (M.I.N.I.): the development and validation of a structured diagnostic psychiatric interview for DSM-IV and ICD-10. J Clin Psychiatry. 1998;59 Suppl 20:22–33. quiz 34-57.PubMed
35.
Spielberger C. Manual for the Sate-Trait anxiety Inventory (Form Y). Palo Alto, CA: Consulting Psychologists Press; 1983.
36.
Schafer J. Analysis of Incomplete Multivariate Data. London: Chapman & Hall; 1997.CrossRef
37.
Chew ML, Mulsant BH, Pollock BG, Lehman ME, Greenspan A, Mahmoud RA, Kirshner MA, Sorisio DA, Bies RR, Gharabawi G. Anticholinergic activity of 107 medications commonly used by older adults. J Am Geriatr Soc. 2008;56(7):1333–41.CrossRefPubMed
38.
Sneed JR, Culang ME, Keilp JG, Rutherford BR, Devanand DP, Roose SP. Antidepressant medication and executive dysfunction: a deleterious interaction in late-life depression. Am J Geriatr Psychiatry. 2010;18(2):128–35.CrossRefPubMedPubMedCentral
39.
Han L, McCusker J, Cole M, Capek R, Abrahamowicz M. Antidepressant use and cognitive functioning in older medical patients with major or minor depression: a prospective cohort study with database linkage. J Clin Psychopharmacol. 2011;31(4):429–35.CrossRefPubMedPubMedCentral
40.
Little R, Rubin D. Statistical analysis with missing data. New York: Wiley and Sons; 1987.
41.
Olfson M, Blanco C, Marcus SC. Treatment of Adult Depression in the United States. JAMA Intern Med. 2016;176(10):1482–91.CrossRefPubMed
Metadata
Title
Antidepressant use and cognitive decline in community-dwelling elderly people – The Three-City Cohort
Authors
Isabelle Carrière
Joanna Norton
Amandine Farré
Marilyn Wyart
Christophe Tzourio
Pernelle Noize
Karine Pérès
Annie Fourrier-Réglat
Karen Ritchie
Marie Laure Ancelin
Publication date
01-12-2017
Publisher
BioMed Central
Published in
BMC Medicine / Issue 1/2017
Electronic ISSN: 1741-7015
DOI
https://doi.org/10.1186/s12916-017-0847-z

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