eprintid: 10109247 rev_number: 30 eprint_status: archive userid: 608 dir: disk0/10/10/92/47 datestamp: 2020-09-06 10:38:41 lastmod: 2021-11-12 23:52:10 status_changed: 2020-09-06 10:38:41 type: article metadata_visibility: show creators_name: Xu, Z creators_name: Yang, J creators_name: Lau, KK creators_name: Yip, PSF creators_name: Wong, I creators_name: Zhang, Q title: Understanding the association between antidepressants and the risk of being diagnosed with dementia in older people: a self-controlled case series study ispublished: pub divisions: UCL divisions: B02 divisions: C08 divisions: D10 divisions: G11 keywords: Alzheimer’s disease, antidepressants, causal associations, dementia, self-controlled case series studies note: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions. abstract: Background: Given concerns about adverse outcomes for older people taking antidepressants in the literature, we investigated whether taking antidepressants elevates the risk of dementia. Objective: This study aims to investigate the putative association of antidepressants with the risk of dementia. Methods: We conducted a population-based self-controlled case series analysis of older people with dementia and taking antidepressants, using territory-wide medical records of 194,507 older patients collected by the Hospital Authority of Hong Kong, to investigate the association between antidepressant treatment and the risk of developing dementia in older people. Results: There was a significantly higher risk of being diagnosed with dementia during the pre-drug-exposed period (incidence rate ratio (IRR) 20.42 (95% CI: 18.66–22.34)) compared to the non-drug-exposed baseline period. The IRR remained high during the drug-exposed period (IRR 8.86 (7.80–10.06)) before returning to a baseline level after washout (IRR 1.12 (0.77–1.36)). Conclusion: The higher risk of dementia before antidepressant treatment may be related to emerging psychiatric symptoms co-occurring with dementia, which trigger medical consultations that result in a decision to begin antidepressants. Our findings do not support a causal relationship between antidepressant treatment and the risk of dementia. date: 2020-11-10 date_type: published publisher: IOS Press official_url: https://doi.org/10.3233/JAD-200875 oa_status: green full_text_type: other language: eng primo: open primo_central: open_green verified: verified_manual elements_id: 1811165 doi: 10.3233/JAD-200875 lyricists_name: Wong, Ian lyricists_id: ICKWO00 actors_name: Austen, Jennifer actors_id: JAUST66 actors_role: owner full_text_status: public publication: Journal of Alzheimer's Disease volume: 78 number: 2 pagerange: 735-744 citation: Xu, Z; Yang, J; Lau, KK; Yip, PSF; Wong, I; Zhang, Q; (2020) Understanding the association between antidepressants and the risk of being diagnosed with dementia in older people: a self-controlled case series study. Journal of Alzheimer's Disease , 78 (2) pp. 735-744. 10.3233/JAD-200875 <https://doi.org/10.3233/JAD-200875>. Green open access document_url: https://discovery.ucl.ac.uk/id/eprint/10109247/3/Wong_Journal%20of%20Alzheimer%27s%20Disease%202020%20Antidepressant%20and%20Dementia%20final.pdf