Department of Research Programs, Fort Belvoir Community Hospital, Fort Belvoir, Virginia, 22060, USA.
Department of Research, College of Medicine, Sulaiman AlRajhi University, Al Bukayriah, Kingdom of Saudi Arabia.
Ann Clin Transl Neurol. 2022 Aug;9(8):1163-1176. doi: 10.1002/acn3.51614. Epub 2022 Jun 24.
To examine associations of antidepressant, anxiolytic and hypnotic use amongst older women (≥65 years) with incident Parkinson's Disease (PD), using data from Women's Health Initiative linked to Medicare claims.
PD was defined using self-report, first diagnosis, medications and/or death certificates and psychotropic medications were ascertained at baseline and 3-year follow-up. Cox regression models were constructed to calculate adjusted hazard ratios (aHR) with 95% confidence intervals (CI), controlling for socio-demographic, lifestyle and health characteristics, overall and amongst women diagnosed with depression, anxiety and/or sleep disorders (DASD).
A total of 53,996 WHI participants (1,756 PD cases)-including 27,631 women diagnosed with DASD (1,137 PD cases)-were followed up for ~14 years. Use of hypnotics was not significantly associated with PD risk (aHR = 0.98, 95% CI: 0.82, 1.16), whereas PD risk was increased amongst users of antidepressants (aHR = 1.75, 95% CI: 1.56, 1.96) and anxiolytics (aHR = 1.48, 95% CI: 1.25, 1.73). Compared to non-users of psychotropic medications, those who used 1 type had ~50% higher PD risk, whereas those who used ≥2 types had ~150% higher PD risk. Women who experienced transitions in psychotropic medication use ('use to non-use' or 'non-use to use') between baseline and 3-year follow-up had higher PD risk than those who did not. We obtained similar results with propensity scoring and amongst DASD-diagnosed women.
The use of antidepressants, anxiolytics or multiple psychotropic medication types and transitions in psychotropic medication use was associated with increased PD risk, whereas the use of hypnotics was not associated with PD risk amongst older women.
利用妇女健康倡议（Women's Health Initiative）的数据与医疗保险索赔相关联，检查老年女性（≥65 岁）使用抗抑郁药、抗焦虑药和催眠药与帕金森病（Parkinson's Disease，PD）发病之间的关联。
使用自我报告、首次诊断、药物和/或死亡证明来定义 PD，并在基线和 3 年随访时确定精神药物的使用情况。使用 Cox 回归模型计算调整后的危险比（adjusted hazard ratios，aHR）及其 95%置信区间（confidence intervals，CI），控制社会人口统计学、生活方式和健康特征、总体以及诊断为抑郁、焦虑和/或睡眠障碍（depression，anxiety and/or sleep disorders，DASD）的女性。
共有 53996 名 WHI 参与者（1756 例 PD 病例）-包括 27631 名患有 DASD 的女性（1137 例 PD 病例）-随访时间约为 14 年。催眠药物的使用与 PD 风险无显著相关性（aHR=0.98，95%CI：0.82，1.16），而抗抑郁药（aHR=1.75，95%CI：1.56，1.96）和抗焦虑药（aHR=1.48，95%CI：1.25，1.73）的使用与 PD 风险增加相关。与未使用精神药物的患者相比，使用 1 种药物的患者 PD 风险增加约 50%，而使用≥2 种药物的患者 PD 风险增加约 150%。与未经历过精神药物使用转换（从使用到不使用或从不使用到使用）的患者相比，经历过精神药物使用转换的患者 PD 风险更高。我们通过倾向评分和 DASD 诊断女性患者也获得了类似的结果。
使用抗抑郁药、抗焦虑药或多种精神药物类型以及精神药物使用的转换与 PD 风险增加相关，而催眠药物的使用与老年女性 PD 风险无关。
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