Antidepressants improve cognition in people with late-life depression

Use of antidepressant medication may lead to improvements in some areas of cognitive function, such as memory and learning, in individuals with late-life depression (LLD), a study has shown.

“This effect may be mediated by an improvement in depressive symptoms,” said the investigators who performed a systematic review and meta-analysis of prospective studies of antidepressant pharmacotherapy for adults with LLD aged 50 years and above.

The databases of Medline, Embase, and PsychInfo were searched through 31 December 2022. Participants were excluded if they had bipolar disorder, psychotic depression, dementia, or neurological disease. The investigators combined findings from eligible studies at a descriptive level, and they pooled the results for meta-analysis using a random-effects model.

Twenty-two studies met the eligibility criteria. Thirteen of 19 studies reported improvements on at least one cognitive test following antidepressant treatment. Evidence was strongest for the memory and learning (nine of 16 studies) and processing speed (seven of 10 studies) domains, as well as for sertraline (all five studies).

In six of seven relevant studies, an association was seen between improvements in depressive symptoms and improvement in cognitive test scores.

In the meta-analysis of eight studies involving 493 participants, memory and learning saw statistically significant overall improvements (five studies: effect size, 0.254, 95 percent confidence interval [CI], 0.103‒0.404). Other cognitive domains did not show any statistically significant changes.

The risk of publication bias was low.

“Studies comparing individuals receiving pharmacotherapy with untreated control participants are needed,” the investigators said.