Factors associated with changes in antidepressant use in a community-dwelling elderly cohort: the Three-City Study.
OBJECTIVE
This study aimed to examine changes in antidepressant use in an elderly population over a 2-year period and to determine which factors could predict these changes.


METHODS
This longitudinal study was conducted in 8,061 French community-dwelling subjects aged 65 years and over. At each wave, data on antidepressant use and general health status were collected and depressive symptoms were evaluated using a standardized instrument. Logistic regression models were used to identify baseline predictors of subsequent changes in antidepressant use.


RESULTS
Prevalence of antidepressant use increased from 7.0% at baseline to 8.6% at 2-year follow-up. Selective serotonin reuptake inhibitors (SSRI) accounted for the main part of this increase. Four percent of the baseline nonusers took antidepressants 2 years later. This change was significantly associated with female gender, older age, higher education level, elevated depressive symptoms at baseline, history of major depression, poor self-perceived health, high consumption of nonpsychotropic drugs and cognitive impairment (in particular dementia). Approximately 5% of the elderly population was treated with antidepressants at both examinations, and most of them reported using the same class of antidepressant. Antidepressant withdrawal occurred in only 30% of antidepressant users; we did not find any factor significantly associated with termination of antidepressant use.


CONCLUSIONS
In this large elderly population, the proportion of antidepressant users increased by 23% over a 2-year period. Increasing use was found in all age groups. Our data suggested that many elderly people are chronic users of antidepressants independently of their depression status.
Soudry
Agnès
A
Institut National de la Santé et de la Recherche Médicale (INSERM-U708), Paris, France.
Dufouil
Carole
C
Ritchie
Karen
K
Dartigues
Jean-François
JF
Tzourio
Christophe
C
Alpérovitch
Annick
A
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000928:Antidepressive Agents / Q000627:therapeutic use*; D003072:Cognition Disorders / Q000150:complications; D015331:Cohort Studies; D003866:Depressive Disorder / Q000188:drug therapy*; D004522:Educational Status; D005260:Female; D005500:Follow-Up Studies; D006304:Health Status; D006801:Humans; D016015:Logistic Models; D008297:Male; D015995:Prevalence; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use; D012737:Sex Factors; D011795:Surveys and Questionnaires; D013997:Time Factors
D000928:Antidepressive Agents; D017367:Selective Serotonin Reuptake Inhibitors