Antidepressant use and functional limitations in U.S. older adults

• We examined antidepressant use in relation to functional limitation in older adults.
• Prior-year antidepressant use prospectively predicted functional limitation onset.
• The relationship was only present in long-term antidepressant users and nondepressed.
• The relationship differed across functional limitation category.

ObjectiveThe upsurge in prevalence and long-term use of antidepressants among older adults might have profound health implications beyond depressive symptom management. This study examined the relationship between antidepressant use and functional limitation onset in U.S. older adults.MethodsStudy sample came from 2006 and 2008 waves of the Health and Retirement Study, in combination with data from 2005 and 2007 Prescription Drug Study. Self-reported antidepressant use was identified based on the therapeutic classification of Cerner Multum's Lexicon. Functional limitations were classified into those pertaining to physical mobility, large muscle function, activities of daily living, gross motor function, fine motor function, and instrumental activities of daily living. Cox proportional hazard models were performed to assess the effects of antidepressant use on future functional limitation onset by limitation category, antidepressant type, and length of use, adjusted by depression status and other individual characteristics.ResultsAntidepressant use for one year and longer was associated with an increase in the risk of functional limitation by 8% (95% confidence interval = 4%–12%), whereas the relationship between antidepressant use less than a year and function limitation was statistically nonsignificant. Antidepressant use was associated with an increase in the risk of functional limitation by 8% (3%–13%) among currently nondepressed participants but not currently depressed participants.ConclusionLong-term antidepressant use in older adults should be prudently evaluated and regularly monitored to reduce the risk of functional limitation. Future research is warranted to examine the health consequences of extended and/or off-label antidepressant use in absence of depressive symptoms.