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Antidepressant Use and Cognitive Outcomes in Very Old Women
Open accessAbstract
Background: Antidepressant use is very common in the elderly, but the effects of antidepressants on cognition in the elderly are controversial with some studies suggesting harm and others protection. We aimed to investigate the association between different antidepressant use and change in cognition and risk of mild cognitive impairment (MCI) or dementia in very old women. Methods: We examined 1,234 community-dwelling women (mean age 83.2 years) from the Study of Osteoporotic Fractures. Baseline antidepressant use was reported and verified by medication containers, and medications were coded with computerized dictionary. Cognitive status (normal, MCI, or dementia) was adjudicated by an expert clinical panel 5 years later. Change in a short-form Mini-Mental State Examination and Trails B were evaluated over 5 years. Results: Eleven per cent of the women were taking antidepressants. Users of selective serotonin reuptake inhibitors (SSRIs) had the greatest cognitive decline over 5 years, after adjustment for demographics, medical comorbidities, benzodiazepine use, and baseline cognition. Multivariable logistic regression shows that the users of SSRIs were more than twice (OR = 2.69, 95% CI = 1.64-4.41) and trazodone users more than three times (3.48, 1.12-10.81) as likely to develop MCI or dementia compared with the nonusers. Further adjustment for baseline cognition or depressive symptoms did not appreciably alter the results, and the association remained after excluding women with high depressive symptoms. The use of tricyclic antidepressants or other antidepressants was not significantly associated with cognitive outcomes. Conclusions: The use of antidepressants, especially SSRIs and trazodone, was associated with an increased risk of cognitive impairment 5 years later among the oldest old women.
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Few published studies have examined the effect of antidepressant use on cognitive decline.
“but few published studies have examined the effect of antidepressant use on cognitive decline, 11,16”
From Antidepressant use in relation to dementia risk, cognitive decline, and brain atrophy (2024) · cites this paper as [11]
The Abstract describes a growing number of studies on the cognitive effects of antidepressants and cites several that examined cognitive decline. It says few studies examined the effects of *different classes* of antidepressants, a narrower gap than the citing sentence describes. The source therefore supports limited research on that specific question, but not the unqualified claim that few studies examined antidepressant use and cognitive decline. (LLM, conf=0.78)
Experimental — accuracy not yet measuredThe study's findings are consistent with prior studies.
“Our findings are consistent with prior studies [12, 20-22, 27, 36].”
From Long-Term Antidepressant Use and Dementia Risk: A Propensity Score-Matched Study of Swiss Older Adults, with an Anticholinergic-Specific Analysis (2026) · cites this paper as [36]
Prior cohort studies on antidepressant use and dementia risk have produced contrasting results.
“Long-term observational data are needed, but cohort studies to date have produced contrasting results. While various studies observed increased risk of dementia in antidepressant users, 4,8-14 several others did not. 15-19”
From Antidepressant use in relation to dementia risk, cognitive decline, and brain atrophy (2024) · cites this paper as [11]
Other studies did link antidepressant use to increased dementia risk.
“In contrast, other studies did link antidepressant use to increased dementia risk. 4,8-14”
From Antidepressant use in relation to dementia risk, cognitive decline, and brain atrophy (2024) · cites this paper as [11]
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Antidepressant use in relation to dementia risk, cognitive decline, and brain atrophy
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Metadata
- Authors
- Leng, Y., Diem, S. J., Stone, K. L., & Yaffe, K.
- Affiliations
- San Francisco VA Medical Center (US)
- University of Minnesota (US)
- California Pacific Medical Center (US)
- Corresponding author
- Yaffe, Kristine
- Venue
- The Journals of Gerontology: Series A
- Publisher
- Oxford University Press (OUP)
- Published
- 2017-12-12
- Volume
- 73
- Issue
- 10
- Pages
- 1390-1395
- ISSN
- 1079-5006 (ISSN-L)
- 1758-535X
- PMC
- PMC6132122
- OpenAlex
- W2771296898
- Cited by
- 48
- References
- 7
- Citations by year
- 2026: 7 · 2025: 6 · 2024: 8 · 2023: 6 · 2022: 7 · 2021: 8 · 2020: 4 · 2019: 2
- FWCI
- 1.24
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- The Journals of Gerontology Series A (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- eScholarship (California Digital Library) (submittedVersion)
- Funders
- National Institutes of Health
- National Institute on Aging (R01 AG005407, R01 AR35582, R01 AR35583, R01 AR35584, R01 AG005394, R01 AG027574, R01 AG027576, R01 AG026720, K24 AG031155, 1K99AG056598-01)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Health Sciences › Medicine › Geriatrics and Gerontology › Pharmaceutical Practices and Patient Outcomes
- Health Sciences › Medicine › Pharmacology (medical) › Treatment of Major Depression
- Keywords
- antidepressant use, cognitive decline, mild cognitive impairment, dementia, selective serotonin reuptake inhibitors, trazodone, tricyclic antidepressants, oldest old, geriatric depression, cognitive aging
- MeSH terms
- Aged, Aged, 80 and over, Antidepressive Agents, Antidepressive Agents, Tricyclic, Cognition, Dementia, Depression, Female, Humans, Longitudinal Studies, Risk Factors, Trazodone, United States, Logistic Models, Selective Serotonin Reuptake Inhibitors, Neuroprotective Agents, Cognitive Dysfunction
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