Use of psychotropic medication linked to dementia following SARS-CoV-2 infection

Older patients taking psychotropic medication were about three times more likely to develop dementia following a SARS-CoV-2 infection, researchers reported in Frontiers in Medicine.

Liron Sinvani, MD, assistant professor at the Institute of Health System Science at the Feinstein Institutes, and colleagues assessed electronic health records of 1,755 adults aged 65 years and older to determine the 1-year incidence rate of post-COVID-19 dementia, as well as the association between that and psychotropic medication use.

“COVID-19 can have a profound, lingering effect on a person's physical and mental health, particularly in older adults,” Sinvani said in a press release from the Feinstein Institutes for Medical Research.

Sinvani and colleagues enrolled participants who were hospitalized with COVID-19 between March 1, and April 20, 2020. Logistic regression models were used to assess association between dementia and psychotropic medication use.

Medications assessed consisted of antipsychotics, antidepressants, benzodiazepines for stress and anxiety, mood stabilizers, anticonvulsants and anti-Parkinson disease medications.

After 1 year, 12.7% of patients (n = 223) developed dementia. Out of all participants, 25% (n = 438) were exposed to at least one psychotropic before their COVID-19 diagnosis.

Taking a psychotropic medication prior to COVID-19 was significantly associated with a greater 1-year incidence of post-COVID dementia (OR = 2.7; 95% CI, 1.8-4).

“We know that preexisting psychiatric illness is associated with poor COVID-19 outcomes, but our study is the first to show an association with certain psychiatric medications and dementia,” Sinvani said.

When the authors restricted the analysis of the study to the participants who had at least one documented neurologic or psychiatric diagnosis at the time of their COVID-19 diagnosis, the association “remained robust,” the authors wrote — OR = 3.09; 95% CI, 1.5-6.6.

When differentiating the drug classes, antipsychotics (OR = 2.8; 95% CI, 1.7-4.4) and mood stabilizers/anticonvulsants (OR = 2.4; 95% CI, 1.39-4.02) displayed the greatest association with post-COVID-19 dementia.

“This research shows that psychotropic medications can be considered a predictive risk marker for post-COVID dementia,” Yun Freudenberg-Hua, MD, coauthor of the study and associate professor in the division of geriatric psychology at Northwell Health, said in the release. “In patients taking psychotropic medications, COVID-19 could have accelerated progression of dementia after hospitalization.”

References:

Business Wire. COVID-19 study links psychotropic medication to increased risk of dementia in older adults. https://www.businesswire.com/news/home/20220321005614/en. Published March 21, 2022. Accessed March 28, 2022.

Freudenberg-Hua Y, et al. Front Med. 2022;doi:10.3389/fmed.2022.841326.