期刊
JOURNAL OF THE AMERICAN GERIATRICS SOCIETY
卷 65, 期 5, 页码 1043-1050出版社
WILEY
DOI: 10.1111/jgs.14756
关键词
PTSD; dementia; psychotropic drugs; veterans
资金
- Department of Veterans Affairs Health Services Research and Development Service [CDA 10-016]
ObjectiveTo determine the associations between PTSD, psychotropic medication use, and the risk for dementia. DesignRetrospective cohort. ParticipantsNationwide sample of US veterans (N = 417,172) aged 56 years during fiscal year (FY) 2003 without a diagnosis of dementia or mild cognitive impairment at baseline (FY02-03) and 1 clinical encounter every 2 years during follow-up (FY04-12). MeasuresDemographic characteristics; diagnosis of PTSD, dementia, and medical and psychiatric comorbidity (defined by ICD-9 codes); and psychotropic medication use including selective serotonin reuptake inhibitors (SSRI), serotonin-norepinephrine reuptake inhibitors (SNRI), novel antidepressants (NA), benzodiazepines (BZA), and atypical antipsychotics (AA). Cox proportional hazard models examined for associations between PTSD diagnosis, psychotropic medication use, and risk for a dementia diagnosis. ResultsPTSD diagnosis significantly increased the risk for dementia diagnosis (HR = 1.35; [95% CI = 1.27-1.43]). However, there were significant interactions between PTSD diagnosis and use of SSRIs (P < .001), NAs (P = .014), and AAs (P < .001) on the risk for dementia diagnosis. HR for dementia diagnosis among veterans diagnosed with PTSD and not using psychotropic medications was 1.55 [1.45-1.67]. Among veterans diagnosed with PTSD prescribed SSRI, SNRI, or AA, HR for dementia diagnosis varied by drug class use ranging from 1.99 for SSRI to 4.21 for AA, relative to veterans without a PTSD diagnosis and no psychotropic medication receipt. BZAs or SNRIs use at baseline was associated with a significantly increased risk for dementia diagnosis independent of a PTSD diagnosis. ConclusionPTSD diagnosis is associated with an increased risk for dementia diagnosis that varied with receipt of psychotropic medications. Further research would help to delineate if these findings are due to differences in PTSD severity, psychiatric comorbidity, or independent effects of psychotropic medications on cognitive decline.
作者
我是这篇论文的作者
点击您的名字以认领此论文并将其添加到您的个人资料中。
推荐
暂无数据