当前位置： SCI文献检索 > Alzheimers Research & Therapy期刊下所有文献 > Risk of head and traumatic brain injuries associated with antidepressant use among community-dwelling persons with Alzheimer's disease: a nationwide matched cohort study.

Risk of head and traumatic brain injuries associated with antidepressant use among community-dwelling persons with Alzheimer's disease: a nationwide matched cohort study.

Abstract：

BACKGROUND:Antidepressant use has been associated with an increased risk of falling, but no studies have been conducted on whether antidepressant use is associated with an increased risk of head injuries which often result from falling among older persons. The objective of this study was to investigate the risk of head and brain injuries associated with antidepressant use among community-dwelling persons with Alzheimer's disease. METHODS:A matched cohort study was conducted by comparing new antidepressant users (n = 10,910) with two matched nonusers (n = 21,820) in the MEDALZ study cohort. The MEDALZ cohort includes all community-dwelling persons newly diagnosed with Alzheimer's disease between 2005 and 2011 in Finland. Incident antidepressant users were identified based on register-based dispensing data from the Prescription register with a 1-year washout period for antidepressant use. Nonusers were matched with users based on age, gender, and time since Alzheimer's disease diagnosis. The outcome events were defined as any head injuries and traumatic brain injuries based on diagnoses in Hospital Discharge and Causes of Death registers. Propensity score adjusted Cox proportional hazard models were utilized. Sensitivity analyses with case-crossover design were conducted. All registers are linkable with unique personal identification numbers assigned for each resident. RESULTS:Antidepressant use was associated with an increased risk of head injuries (age-adjusted event rate per 100 person-years 2.98 (95% confidence interval (CI) 2.49-3.06) during use and 2.43 (95% CI 2.06-2.35) during nonuse, adjusted hazard ratio (HR) 1.35, 95% CI 1.20-1.52) and traumatic brain injuries (age-adjusted event rate per 100 person-years 1.33 (95% CI 1.13-1.53) during use and 1.10 (95% CI 1.00-1.20) during nonuse, adjusted HR 1.26, 95% CI 1.06-1.50). The risk was highest during the first 30 days of use (HR 1.71, 95% CI 1.10-2.66 for head injuries; HR 2.06, 95% CI 1.12-3.82 for traumatic brain injuries) and remained at an elevated level for head injuries for over 2 years of use. In case-crossover analyses, antidepressant use was consistently associated with a higher risk of head injuries. CONCLUSIONS:Antidepressant use was associated with an increased risk of the most severe outcomes, head and brain injuries, in persons with Alzheimer's disease. Antidepressant use should be carefully considered and the association confirmed in future studies.

journal_name

Alzheimers Res Ther

journal_title

Alzheimer's research & therapy

authors

Taipale H,Koponen M,Tanskanen A,Lavikainen P,Sund R,Tiihonen J,Hartikainen S,Tolppanen AM

doi

10.1186/s13195-017-0285-3

subject

Has Abstract

pub_date

2017-08-01 00:00:00

pages

issue

issn

1758-9193

pii

10.1186/s13195-017-0285-3

journal_volume

pub_type

杂志文章

在线工具

Risk of head and traumatic brain injuries associated with antidepressant use among community-dwelling persons with Alzheimer's disease: a nationwide matched cohort study.