Taking antidepressants for late-life depression may improve certain aspects of cognitive function, particularly memory and learning, a review and meta-analysis in the American Journal of Psychiatry suggests.
Nicholas J. Ainsworth, M.D., of the Centre for Addiction and Mental Health in Toronto and colleagues analyzed data from 22 studies (totaling 3,019 participants) of antidepressant therapy for older adults (study participants had a minimum age of 50 or average age of 65 or older) with depression that included cognitive testing. The researchers categorized cognitive tests in the following domains: global cognition, executive function, processing speed, verbal memory and learning, immediate memory, attention and working memory, and verbal fluency.
Ainsworth and colleagues sought answers to three questions:
- Does pharmacological treatment of late-life depression lead to improved cognition, either globally or in specific cognitive domains?
- Do specific antidepressants improve cognition more than others?
- Are improvements in cognition after pharmacotherapy associated with improvements in depressive symptoms?
- The researchers classified a study as reporting “improvement” in a cognitive domain when an antidepressant showed statistically significant differences from baseline to posttreatment (compared with placebo or another antidepressant, if applicable) in one or more cognitive tests.
For the first question, a meta-analysis of eight relevant studies found that treatment with an antidepressant did lead to modest, but statistically significant, improvements in learning and memory in adults with late-life depression. Several studies reported cognitive improvement in processing speed with antidepressant therapy, but the findings did not reach statistical significance.
There were not enough data to address the other two questions with a meta-analysis, but a qualitative review suggested sertraline had the most consistent evidence of benefit; all five studies involving sertraline reported an improvement in at least one cognitive domain. The researchers also found that seven of eight relevant studies found some association between improvements in depression and cognition.
“Future prospective [late-life depression] research studies should systematically test cognitive outcomes in multiple domains, while including a nontreatment comparator group to account for possible practice effects,” the researchers concluded.
For related information, see the American Journal of Psychiatry article “Optimizing the Treatment of Late-Life Depression.”
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