Television Watching, Computer Use Found to Have Opposite Impact on Dementia Risk

A study published in PNAS has found that older adults who spend many hours a day watching television are at increased risk of developing dementia, but those who spend more than an hour daily on a computer have a slightly reduced risk of dementia. These findings remained strong regardless of how much or little the adults engaged in physical activity.

“Our results help clarify associations of [sedentary behavior] with brain health and suggest that it is not time spent sitting per se but the type or context of leisure-time [sedentary behavior] that is associated with dementia risk,” wrote David A. Raichlen, Ph.D., of the University of Southern California and colleagues.

Raichlen and colleagues used data from the UK Biobank, a database that contains both baseline and follow-up health, lifestyle, and genetic information from about half a million adults in the UK. For their analysis, Raichlen and colleagues examined data on 146,651 participants who were at least 60 years old and dementia-free at the baseline assessment. During the follow-up period (average of 12 years), 3,507 of these adults developed dementia.

The researchers found that adults who spent 4 hours a day or more watching TV had about 20% greater risk of developing dementia than those who spent less than 2 hours a day watching TV. In contrast, adults who spent 1 hour or more on a computer daily had a 24% reduced risk of dementia compared with those who spent less than 30 minutes on a computer. The amount of physical activity in which subjects engaged did not significantly impact these estimated risks.

“While [physical activity] is associated with a beneficial reduction in dementia risk, this relationship does not strongly impact associations between leisure-time [sedentary behaviors] and dementia risk, suggesting two key and potentially separate behavioral pathways for altering risk of incident dementia,” Raichlen and colleagues wrote.

“[O]ur results highlight a key behavioral characteristic for public health messaging and modification,” the authors concluded. “Reducing cognitively passive [sedentary behaviors] like TV watching and increasing cognitively active [sedentary behaviors] like computer use, by even a small amount, may have an important impact on dementia risk in individuals regardless of their engagement in [physical activity].”

To read more on this topic, see the Psychiatric News Alert “Study Pinpoints Activities Associated With Reduced Risk of Cognitive Decline.”

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Taking Antidepressants After Age 60 May Increase Dementia Risk, Study Finds

People who take antidepressants after age 60 may face a greater risk of dementia than those who don’t take antidepressants, a study in the American Journal of Geriatric Psychiatry has found.

Arad Kodesh, M.D., of the University of Haifa in Israel and colleagues analyzed the health records of 71,515 people aged 60 years or older from Israel. As far back as 2002, the participants had no diagnosis of dementia or record of taking medications for dementia. No participants had taken an antidepressant in 2012. The researchers then followed the participants from May 2013 to October 2017.

During follow-up, 3,688 participants had received and filled prescriptions for an antidepressant for at least 60 days. Of those, 11% developed dementia. In contrast, only 2.6% of those who did not take antidepressants developed dementia. After adjusting for other conditions linked to dementia risk, the researchers found that the risk of dementia in those who took an antidepressant was 3.43 times greater than those who did not.

“This is a considerable increase in risk and may be compared to other risk factors for dementia that have around a 1.6-fold increased dementia risk, e.g., smoking, and BMI [body mass index],” Kodesh and colleagues wrote.

The researchers found the increased risk to be consistent across different classes of antidepressants, with two notable exceptions: Compared with those who did not take antidepressants, those who took amitriptyline had twice the risk of developing dementia, and those who took paroxetine had more than five times the risk.

In noting the limitations of their study, the researchers wrote that their results could “mimic the [known] association between depression and dementia rather than the effect of taking an antidepressant.”

Nonetheless, they emphasized the importance of careful prescribing in older patients.

“Clinicians, caregivers, and patients may wish to consider this potential negative consequence of antidepressant exposure with the objective of balancing the adverse events and symptomatic benefits of monotherapeutic antidepressant medication in old age,” they wrote.

For related information, see the Psychiatric News article “Percentage of Americans Taking Antidepressants Climbs.”

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Long-Term Use of Antidepressants Doesn’t Increase Dementia Risk, Study Finds

While the long-term use of most antidepressants does not appear to increase the risk of dementia, long-term use of the selective serotonin reuptake inhibitor (SSRI) paroxetine may, suggests a study in the Journal of the American Geriatrics Society.

Laura Heath, Ph.D., of the University of Washington and colleagues examined the health data of 3,059 older adults who were part of Kaiser Permanente Washington’s Adult Changes in Thought (ACT) study, a longitudinal study tracking brain changes prior to the onset of dementia.

The investigators used this longitudinal data to compare dementia rates in patients with cumulative antidepressant use, which was divided into four categories of medication exposure over the previous decade: none, low (1 to 90 days), medium (90 days to one year), high (1 to 3 years), and very high (3+ years). Antidepressants were also grouped into five categories: paroxetine, other SSRIs, serotonin antagonist and reuptake inhibitors (SARIs), tricyclic antidepressants, and all other antidepressants.

Heath and colleagues identified no association between antidepressant use and dementia risk for most groups of antidepressants, regardless of how much medication people took. In contrast, some patients with a history of paroxetine use (high and low use groups) were found to be at a statistically significant increased risk of dementia compared with those with no antidepressant use; patients in the medium and very high categories also showed higher risk, but it was not significant. The authors suggested these findings point to paroxetine posing a dementia risk that is not based on cumulative exposure to the medication.

The authors also found that patients with a low exposure to SARIs such as trazodone had a slightly lower risk of dementia. Some preclinical evidence has hinted that trazodone might have neuroprotective properties, but this connection needs further investigation, the authors said.

“Given the primary results and the sensitivity analyses that showed higher risk of dementia … in [paroxetine] users with depression than in nonusers with depression, who may already be at higher risk of dementia because of depression, our findings suggest that some caution may be warranted in prescribing paroxetine for depression in older adults,” the authors concluded.

For related information, see the Psychiatric News article “Long-Term SSRI Use May Slow Progression to Alzheimer’s Dementia.”

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