Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience (MHeNs), Alzheimer Centre Limburg (ACL), Maastricht University, Maastricht, The Netherlands.
Department of Old Age Psychiatry, Mondriaan Hospital, Heerlen, The Netherlands.
J Psychopharmacol. 2022 May;36(5):578-593. doi: 10.1177/02698811221080462. Epub 2022 Apr 29.
Selective serotonin reuptake inhibitors (SSRIs) are commonly prescribed to older adults. In contrast to young subjects, it is unclear whether older adults may be vulnerable to cognitive side effects. Serotonin is involved in cognitive functions (e.g. memory). It is of great importance to examine the effects of SSRIs on memory functioning in older adults.
The objective of this systematic literature review is to summarize studies in which the effects of SSRI treatment on all aspects of memory functioning in older adults are investigated.
PubMed, PsycINFO, CINAHL, and Embase were searched for all studies published until 18th of October 2021. Articles were included if they fulfilled the inclusion criteria as follows: (1) study design is (randomized) controlled trial, cross-sectional, or prospective cohort study; (2) study population consists of older adults (mean age ⩾65 years), or results for this age-group are reported separately; (3) intervention is use of an SSRI; and (4) effects on performance of any memory domain are measured and clearly described.
The search yielded 1888 articles, of which 136 were included for the full-text review. Eventually, 40 articles were included. Most studies reported no association between SSRI use and memory functioning. The studies that found a positive association mainly investigated older adults with mental or neurological disorders (e.g. depression or stroke). A few studies found a negative association in the following subgroups: non-responders (depression), patients with frontal brain disease, and women.
Overall, no consistent negative effects of SSRIs on memory functioning in older adults were found after SSRI treatment. Most studies reported no change in memory functioning after SSRI use. Some studies even showed an improvement in memory performance. Positive effects of SSRIs on memory functioning were especially found in older adults with mental or neurological disorders, such as subjects with depression or stroke.
选择性 5-羟色胺再摄取抑制剂（SSRIs）常用于治疗老年人。与年轻患者不同，目前尚不清楚老年人是否容易受到认知副作用的影响。5-羟色胺参与认知功能（例如记忆）。因此，研究 SSRIs 对老年人记忆功能的影响非常重要。
本系统文献综述的目的是总结研究 SSRI 治疗对老年人记忆功能各个方面的影响的研究。
检索了 PubMed、PsycINFO、CINAHL 和 Embase，以获取截至 2021 年 10 月 18 日发表的所有研究。如果符合以下纳入标准，则纳入研究：（1）研究设计为（随机）对照试验、横断面研究或前瞻性队列研究；（2）研究人群为老年人（平均年龄 ⩾65 岁），或单独报告了该年龄组的结果；（3）干预措施为使用 SSRI；（4）评估了任何记忆域的表现并清楚地描述了结果。
搜索结果得到 1888 篇文章，其中 136 篇文章进行了全文审查。最终纳入了 40 篇文章。大多数研究报告 SSRIs 使用与记忆功能之间没有关联。发现正相关的研究主要调查了患有精神或神经疾病的老年人（例如抑郁症或中风）。少数研究发现以下亚组存在负相关：无反应者（抑郁症）、额叶脑疾病患者和女性。
总体而言，在 SSRI 治疗后，未发现 SSRIs 对老年人记忆功能产生一致的负面影响。大多数研究报告 SSRI 使用后记忆功能没有变化。一些研究甚至显示记忆表现有所改善。SSRIs 对记忆功能的积极影响在患有精神或神经疾病的老年人中尤其明显，例如患有抑郁症或中风的患者。
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