title: Antidepressant Use and Cognitive Decline: The Health and Retirement Study.
abstract: BACKGROUND
  Depression is associated with cognitive impairment and dementia, but whether treatment for depression with antidepressants reduces the risk for cognitive decline is unclear. We assessed the association between antidepressant use and cognitive decline over 6 years.
  
  
  METHODS
  Participants were 3714 adults aged 50 years or more who were enrolled in the nationally representative Health and Retirement Study and had self-reported antidepressant use. Depressive symptoms were assessed using the 8-item Center for Epidemiologic Studies Depression Scale. Cognitive function was assessed at 4 time points (2004, 2006, 2008, 2010) using a validated 27-point scale. Change in cognitive function over the 6-year follow-up period was examined using linear growth models, adjusted for demographics, depressive symptoms, comorbidities, functional limitations, and antidepressant anticholinergic activity load.
  
  
  RESULTS
  At baseline, cognitive function did not differ significantly between the 445 (12.1%) participants taking antidepressants and those not taking antidepressants (mean, 14.9%; 95% confidence interval, 14.3-15.4 vs mean, 15.1%; 95% confidence interval, 14.9-15.3). During the 6-year follow up period, cognition declined in both users and nonusers of antidepressants, ranging from -1.4 change in mean score in those with high depressive symptoms and taking antidepressants to -0.5 change in mean score in those with high depressive symptoms and not taking antidepressants. In adjusted models, cognition declined in people taking antidepressants at the same rate as those not taking antidepressants. Results remained consistent across different levels of baseline cognitive function, age, and duration of antidepressant use (prolonged vs short-term).
  
  
  CONCLUSIONS
  Antidepressant use did not modify the course of 6-year cognitive change in this nationally representative sample.
authors: Department of Medicine, University of Massachusetts Medical School, Worcester; Meyers Primary Care Institute, Worcester, Mass; Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester. Electronic address: Jane.saczynski@umassmed.edu.
authors: Jane S
authors: JS
authors: Saczynski
authors: Meyers Primary Care Institute, Worcester, Mass; Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester.
authors: Allison B
authors: AB
authors: Rosen
authors: Division of General Medicine, Department of Medicine, University of Michigan Medical School, Ann Arbor.
authors: Ryan J
authors: RJ
authors: McCammon
authors: Department of Veterans Affairs, National Serious Mental Illness Treatment Resource and Evaluation Center, Ann Arbor, Mich; Department of Veterans Affairs, Center for Clinical Management Research, Ann Arbor, Mich; Department of Psychiatry, University of Michigan Medical School, Ann Arbor; Institute for Social Research, University of Michigan, Ann Arbor.
authors: Kara
authors: K
authors: Zivin
authors: Meyers Primary Care Institute, Worcester, Mass.
authors: Susan E
authors: SE
authors: Andrade
authors: Division of General Medicine, Department of Medicine, University of Michigan Medical School, Ann Arbor; Department of Veterans Affairs, Center for Clinical Management Research, Ann Arbor, Mich; Institute for Social Research, University of Michigan, Ann Arbor.
authors: Kenneth M
authors: KM
authors: Langa
authors: Division of General Medicine, Department of Medicine, University of Michigan Medical School, Ann Arbor; Department of Veterans Affairs, Center for Clinical Management Research, Ann Arbor, Mich.
authors: Sandeep
authors: S
authors: Vijan
authors: Department of Medicine, Alpert School of Medicine at Brown University, Providence, RI.
authors: Paul A
authors: PA
authors: Pirraglia
authors: Department of Pharmacy and Health Systems Sciences, Northeastern University, Boston, Mass.
authors: Becky A
authors: BA
authors: Briesacher
mesh_terms: D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D000928:Antidepressive Agents / Q000008:administration & dosage* / Q000009:adverse effects; D003071:Cognition / Q000187:drug effects*; D003430:Cross-Sectional Studies; D003866:Depressive Disorder / Q000175:diagnosis* / Q000188:drug therapy* / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D015577:Geriatric Assessment / Q000379:methods; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D012016:Reference Values; D018570:Risk Assessment; D017678:Sex Distribution; D011795:Surveys and Questionnaires; D014481:United States
chemical_list: D000928:Antidepressive Agents
keywords: Antidepressants; Cognition; Depression; Epidemiology
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