Antidepressants for treating depression among older adults with dementia: A systematic review and meta-analysis.

Autor: Lenouvel E; Department of Old Age Psychiatry and Psychotherapy, University Hospital of Psychiatry, Bern (UPD, Bern), Bern, Switzerland; University of Bern, Graduate School of Health Sciences, Bern, Switzerland. Electronic address: eric.lenouvel@unibe.ch., Tobias S; Faculty of Medicine, University of Ulm, Germany; Department of Psychiatry and Psychotherapy III, Ulm University Hospital, Germany., Mühlbauer V; Department of Psychiatry and Psychotherapy III, Ulm University Hospital, Germany., Dallmeier D; AGAPLESION Bethesda Clinic Ulm, Geriatric Centre Ulm/Alb-Donau, Ulm, Germany; Department of Epidemiology, Boston University School of Public Health, Boston, USA., Denkinger M; AGAPLESION Bethesda Clinic Ulm, Geriatric Centre Ulm/Alb-Donau, Ulm, Germany; Institute for Geriatric Research, University of Ulm Medical Center, Ulm, Germany., Klöppel S; Department of Old Age Psychiatry and Psychotherapy, University Hospital of Psychiatry, Bern (UPD, Bern), Bern, Switzerland., Schönfeldt-Lecuona C; Department of Psychiatry and Psychotherapy III, Ulm University Hospital, Germany; CuraMed Day Clinic for Psychiatry, Psychosomatics and Psychotherapy Neu-Ulm, Germany.
Jazyk: angličtina
Zdroj: Psychiatry research [Psychiatry Res] 2024 Oct; Vol. 340, pp. 116114. Date of Electronic Publication: 2024 Jul 31.
DOI: 10.1016/j.psychres.2024.116114
Abstrakt: Background: Depression and dementia represent significant health challenges in older adults. Despite guidelines recommending antidepressants, their efficacy in depressed patients with dementia remains undetermined.
Objective: This review, in following a living systematic review approach, primarily aims to determine the effect of any-type antidepressant on the level of depressive symptoms in older adults with dementia and secondly if there is an effect of any-type antidepressants on cognitive state, quality of life, and functionality in the old-age population with dementia.
Methods: Systematic review and meta-analysis of RCTs from Medline, Embase, and Cochrane Register. Participants were ≥65 years, with both depression and any type of dementia. Certainty-of-Evidence was assessed through the Cochrane Risk-of-Bias tool and GRADE. Analysis involved standardized mean difference, with 95 % confidence-intervals (CIs).
Findings: Of the 27,771 screened articles, 8 studies (617 participants), treated with SSRI, SSNRI, atypical, and tricyclic antidepressants were retained for quantitative synthesis. No evidence for an effect was found (SMD -0.10 [-0.26, 0.07]), nor when subgrouped based on depression severity or dementia level, nor for secondary outcomes.
Interpretation: This review did not find evidence of a clinical effect of antidepressants for treating depression in older adults with dementia. Methodological challenges might contribute to this finding.
Competing Interests: Declaration of competing interest All authors declare that they have no conflicts of interest.
(Copyright © 2024. Published by Elsevier B.V.)
Databáze: MEDLINE
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