Association between depressive symptoms and use of HMG-CoA reductase inhibitors (statins), corticosteroids and histamine H(2) receptor antagonists in community-dwelling older persons: cross-sectional analysis of a population-based cohort.

BACKGROUND

Strong evidence supporting the existence of causal associations of drug use with depression is often lacking from empirical studies. Limited evidence suggests an inverse association of use of HMG-CoA reductase inhibitors (statins) with depressive symptoms. Sparse and sometimes conflicting data in this respect have also been reported for corticosteroids, histamine H(2) receptor antagonists and antihypertensive agents.

OBJECTIVE

To identify associations between use of different drug classes and depressive symptoms in community-dwelling older patients and to determine whether any such associations varied between young-old and old-old patients.

METHOD

We analysed cross-sectional data from a population-based cohort of 2804 older adults aged > or =55 years, in whom specific drug use was systematically identified from self-reports and physical inspection of medication labels. Depressive symptoms were determined using the 15-item Geriatric Depression Scale (GDS), with a GDS score > or =5 defining the presence of depressive symptoms.

RESULTS

Multivariate analysis controlling for the confounding effects of risk factors and correlates of depression revealed significant associations between depressive symptoms and use of statins (odds ratio [OR] 0.71; 95% CI 0.52, 0.97), histamine H(2) receptor antagonists for patients aged <65 years (OR 4.67; 95% CI 1.59, 13.74) and, in participants aged > or =65 years, systemic corticosteroids (OR 4.02; 95% CI 1.12, 14.42). No convincing associations between the presence of depressive symptoms and use of antihypertensives, antiparkinsonism drugs, NSAIDs and tranquilizers/hypnotic/sedatives were demonstrated.

CONCLUSION

The evidence in this study suggests a possible protective effect of statin use on depressive symptoms, and affirms a positive association between depressive symptoms and corticosteroid use, especially in the older elderly. Use of H(2) receptor antagonists was also associated with depressive symptoms, probably through their link with underlying dyspeptic syndromes.