Antidepressants impair cognitive function in the elderly

June 28, 2000

New medical research provides preliminary evidence that psychoactive drugs such as antidepressants have both immediate and cumulative negative effects on cognitive performance for people age 80 and over.

"These kinds of medications are often prescribed to improve cognitive function. However, this study showed the opposite result. In addition, these drugs are also already associated with a number of negative side effects such as adverse drug reactions, and falls in the elderly," explains Cheryl Dellasega, Ph.D., associate professor of general internal medicine at Penn State and leader of the research team.

"At this point we don't know if the response is dose dependent or the result of the way the drug is administered. We just know that there were negative effects on cognition. Over time persons who took them had lower performance than those who did not, and secondly, persons who began taking them between measurement times showed the worst performance scores, " she notes.

"The implications of this study include that physicians and family members need to be aware that these elderly patients may need help managing their medications," she noted.

Dellasega and Denise Orwig, Ph.D., University of Maryland, Stig Berg, Ph.D., Halsohogskolan, Sweden, and James Walker, M.D., Penn State's College of Medicine, presented their findings, "The Cognitive Consequences of Long-Term Psychoactive Medication Use for the Oldest Old," at the recent American Geriatrics Society Meeting held in Nashville, Tenn.

The three-year study was of 351 people from Sweden age 80 and over. The participants were drawn from the Old-Old (OCTO)-Twin Study, a longitudinal study on this group that tracks every twin in Sweden born in 1913. Each participant was interviewed for approximately three and a half-hours using standard cognitive tests. Questions tested things such as short and long-term memory, reasoning, recognition of everyday items and simple calculations such as balancing a checkbook.

"The subjects were divided into three groups -- those not on any medications, those on psychoactive drugs at the start of the study, and those, who were not on medication at the start of the testing but later had to be put on the psychoactive medications," explains Dellasega. "All three groups tested at age 80 and then at age 82 showed a decline in cognitive function. The group that was not on any medication at the start and then later started taking medication showed the most severe drop in cognitive function."

The Penn State researcher adds that about three-quarters of the entire group were on some kind of psychoactive medication. She reports that results clearly show that those on such medications do not function as well with their day-to-day activities.

The group of people aged 80 and over is one of the fastest growing segments of the population, and Dellasega believes they need more attention to their needs.

"Many of these people take multiple medications daily. More research is needed to examine specific medications within classes to assess the long-tern effectiveness of psychoactive medications, " she says.

Penn State

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