EXPLORING THE ROLE OF SEX, FRAILTY, OR NEUROPATHOLOGY IN THE ANTIDEPRESSANT-ALZHEIMER’S DISEASE ASSOCIATION: A SCOPING REVIEW AND A SECONDARY DATA ANALYSIS

Abstract

Background: Depression is a modifiable risk factor of dementia. The antidepressant-dementia association among older adults remains inconsistent. Methods: Two separate studies — a scoping review and a retrospective study — were conducted. The scoping review assessed whether sex or frailty has been studied as an effect modifier (EM) or confounder of the antidepressant-dementia relationship. The retrospective study assessed whether sex, frailty, or neuropathology modifies the antidepressant-dementia relationship. Results: The scoping review found that frailty was not explored as a confounder or EM in the literature. Sex was not explored as an EM. Studies examining sex as a confounder differed widely in their methodologies. The retrospective study found an association between antidepressant use and clinical dementia (odds ratio 2.65, 95%CI: 1.99-3.54). Male sex, frailty, and neuropathologic burden tended to have weaker antidepressant-dementia association, but this was not statistically significant. Conclusion: More studies are needed to explore potential EMs of the antidepressant-dementia relationship.