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

Key summary points

AbstractSection 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.

AbstractSection 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.

AbstractSection 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.

Abstract

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.

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Acknowledgements

The authors acknowledge the tremendous efforts of the National Cancer Institute and the Centers for Medicare and Medicaid Services; Information Management Services, Inc.; and Surveillance, Epidemiology, and End Results Program in the creation of SEER-Medicare database.

Funding

No external source of funding was received for the present study.

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Correspondence to Yasser Alatawi.

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The authors have declared no conflicts of interest for this study.

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This study was approved by the Auburn University Institutional Review Board.

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Alatawi, Y., Hansen, R.A., Chou, C. et al. The association between antidepressants use and development of cognitive impairment among older women diagnosed with breast cancer. Eur Geriatr Med (2020). https://doi.org/10.1007/s41999-020-00349-4

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Keywords

  • Cognitive impairment
  • Antidepressant
  • Older women
  • Breast cancer