DT‐01‐03: Common Antidepressant Medications and Risk of Dementia: a Prospective Cohort Study

Abstract

The purpose of this study was to determine if antidepressant type was associated with dementia risk. Effects may differ by antidepressant class, as some have known anticholinergic activity (tricyclic antidepressants (TCAs) and paroxetine), which may increase risk, while long-term effects of selective serotonin reuptake inhibitors (SSRIs) are unknown. Adult Changes in Thought (ACT) is a prospective population-based cohort in an integrated health care delivery system. Initial recruitment occurred from 1994-1996 and 2000-2003, followed by continuous enrollment since 2004. For these analyses eligible participants had at least 10 years of enrollment in the health care system at baseline (N=3342, data through December 31, 2013). Primary exposures were SSRIs (paroxetine vs. others) and TCAs. All other antidepressant classes were grouped together and adjusted for in the models. Computerized pharmacy dispensing data were used to ascertain cumulative medication exposure, defined as total number of standardized daily doses (TSDDs) dispensed over a 10-year period (a rolling window from ACT entry and moving forward in time throughout follow-up). The most recent year was excluded to avoid use related to prodromal symptoms. Dementia risk was analyzed using Cox proportional hazards models adjusted for age via the time axis, and for demographic characteristics, health behaviors, and health status. During a mean follow-up of 7.9 years, 864 participants (25.9%) developed dementia (699 Alzheimer…