The association between antidepressants use and development of cognitive impairment among older women diagnosed with breast cancer.

Autor: Alatawi, Yasser, Hansen, Richard A., Chou, Chiahung, Qian, Jingjing, Suppiramaniam, Vishnu, Cao, Guanqun
Zdroj: European Geriatric Medicine; 2020, Vol. 11 Issue 6, p1017-1026, 10p
Abstrakt: Key summary points: Aim: This study aimed to investigate the association between the use of antidepressants and the development of cognitive impairment in older women with breast cancer. Findings: The present study found that the use of non-tricyclic antidepressants was associated with a significantly increased risk of cognitive impairment in older women with breast cancer. Message: The increased use of antidepressants for reasons other than depression might be associated with increased risk of cognitive impairment in older women with breast cancer. Purpose: This study aimed to evaluate the association between the development of cognitive impairment and the use of antidepressants among older women with breast cancer. Methods: This retrospective cohort study used the United States National Cancer Institute's Surveillance, Epidemiology, and End Results-Medicare database to identify women who were 67 years old and older and had breast cancer between 2008 and 2013. Propensity scoring was used to account for confounding pre-treatment factors, and Cox proportional hazards modeling was used to examine the risk of developing cognitive impairment among patients based on whether they used antidepressants. Results: A total of 3174 women taking antidepressants (mean age 75.2 ± 6.4) were matched with 3174 women not taking antidepressants (mean age 75.4 ± 6.7). Antidepressant use was associated with a significantly increased risk of cognitive impairment (hazard ratio [HR]: 1.33, 95%; confidence interval [CI]: 1.18–1.48). Additionally, we found that older women without a history of depression or anxiety who use antidepressants have a higher risk of developing cognitive impairment than those who did not use antidepressants (HR: 1.53, 95%; CI: 1.34–1.75 and HR: 1.39, 95%; CI: 1.23–1.56, respectively). Subgroup analysis showed that the use of non-tricyclic antidepressants (TCAs) was associated with a higher risk of cognitive impairment. Conclusion: We found that non-TCA antidepressant use in older women with breast cancer was associated with a higher risk of cognitive impairment. This association was also observed among older women without depression or anxiety who used antidepressants. [ABSTRACT FROM AUTHOR]
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