Date of Award

8-16-2024

Document Type

Open Access Thesis

Department

Epidemiology and Biostatistics

First Advisor

Matthew Lohman

Abstract

Previous research has indicated that depression is a risk factor for dementia. Since SSRI medication is the most common treatment for depression, it is important to determine if SSRIs are associated with reduced dementia and better cognitive outcomes. Using longitudinal data from the 2004-2014 waves of the Health and Retirement Study merged with the 2005 Prescription Drug Study, we examined potential associations between SSRI and TCA medication and cognitive impairment and cognitive decline. The study population consisted of 1,775 older adults who participated in the PDS in 2005. We found that SSRIs were associated with significantly higher odds of cognitive impairment after two and ten years of follow-up (aOR=3.23, p=.0028; aOR=1.70, p=.0499), while TCA use was not associated with higher odds of cognitive change in either direction at any point. In a linear mixed model, with a time by treatment group interaction term, we found that overall, SSRI users were associated with a significant decline in cognitive score after 10 years of follow-up (aβ=-1.23, p=.0033) when compared to non-SSRI participants. TCAs were not associated with cognitive change in either direction. When stratifying by depression status, depressed SSRI users were associated with a significantly higher decrease in cognition score after 6 years of follow-up (aβ=-2.34, p=.0197) compared to depressed non-SSRI users, though this decrease did not remain significant after 8 and 10 years of follow-up. Depressed TCA users were associated with a significantly higher decline in scores after 4 and 8 years of follow-up (aβ=-4.80, p=.0116; aβ=-4.59, p=.0127) when compared to non-depressed TCA users. Non-depressed SSRI users were associated with a significant decline in cognitive score after 10 years of follow-up (aβ=-1.13, p=.0207), while non-depressed TCA users were not associated with cognitive change in either direction. Future research on this association should aim to further assess the association at varying symptoms of depression and distinguish time of depression onset to clarify the association between both antidepressants and depression with dementia.

Rights

© 2024, Paige Jones

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