Association between depressive symptoms and use of HMG-CoA reductase inhibitors (statins), corticosteroids and histamine H(2) receptor antagonists in community-dwelling older persons: cross-sectional analysis of a population-based cohort.
BACKGROUND
Strong evidence supporting the existence of causal associations of drug use with depression is often lacking from empirical studies. Limited evidence suggests an inverse association of use of HMG-CoA reductase inhibitors (statins) with depressive symptoms. Sparse and sometimes conflicting data in this respect have also been reported for corticosteroids, histamine H(2) receptor antagonists and antihypertensive agents.


OBJECTIVE
To identify associations between use of different drug classes and depressive symptoms in community-dwelling older patients and to determine whether any such associations varied between young-old and old-old patients.


METHODS
We analysed cross-sectional data from a population-based cohort of 2804 older adults aged > or =55 years, in whom specific drug use was systematically identified from self-reports and physical inspection of medication labels. Depressive symptoms were determined using the 15-item Geriatric Depression Scale (GDS), with a GDS score > or =5 defining the presence of depressive symptoms.


RESULTS
Multivariate analysis controlling for the confounding effects of risk factors and correlates of depression revealed significant associations between depressive symptoms and use of statins (odds ratio [OR] 0.71; 95% CI 0.52, 0.97), histamine H(2) receptor antagonists for patients aged <65 years (OR 4.67; 95% CI 1.59, 13.74) and, in participants aged > or =65 years, systemic corticosteroids (OR 4.02; 95% CI 1.12, 14.42). No convincing associations between the presence of depressive symptoms and use of antihypertensives, antiparkinsonism drugs, NSAIDs and tranquilizers/hypnotic/sedatives were demonstrated.


CONCLUSIONS
The evidence in this study suggests a possible protective effect of statin use on depressive symptoms, and affirms a positive association between depressive symptoms and corticosteroid use, especially in the older elderly. Use of H(2) receptor antagonists was also associated with depressive symptoms, probably through their link with underlying dyspeptic syndromes.
Feng
Liang
L
Gerontological Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
Tan
Chay-Hoon
CH
Merchant
Reshma A
RA
Ng
Tze-Pin
TP
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002986:Clinical Trials as Topic; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D003863:Depression / Q000453:epidemiology / Q000209:etiology*; D005260:Female; D005938:Glucocorticoids / Q000009:adverse effects*; D006635:Histamine H2 Antagonists / Q000009:adverse effects*; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000009:adverse effects / Q000494:pharmacology*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011569:Psychiatric Status Rating Scales; D012307:Risk Factors
D005938:Glucocorticoids; D006635:Histamine H2 Antagonists; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors