Department of Research Programs, A.T. Augusta Military Medical Center, 9300 DeWitt Loop, Fort Belvoir, VA, 22060, USA.
Laboratory of Epidemiology and Population Sciences, National Institute on Aging, NIA/NIH/IRP, Baltimore, MD, USA.
Geroscience. 2024 Dec;46(6):5797-5817. doi: 10.1007/s11357-024-01141-z. Epub 2024 Mar 22.
To examine cross-sectional and longitudinal relationships of psychotropic medications with physical function after menopause. Analyses involved 4557 Women's Health Initiative Long Life Study (WHI-LLS) participants (mean age at WHI enrollment (1993-1998): 62.8 years). Antidepressant, anxiolytic, and sedative/hypnotic medications were evaluated at WHI enrollment and 3-year follow-up visits. Performance-based physical function [Short Physical Performance Battery (SPPB)] was assessed at the 2012-2013 WHI-LLS visit. Self-reported physical function [RAND-36] was examined at WHI enrollment and the last available follow-up visit-an average of 22 [±2.8] (range: 12-27) years post-enrollment. Multivariable regression models controlled for socio-demographic, lifestyle, and health characteristics. Anxiolytics were not related to physical function. At WHI enrollment, antidepressant use was cross-sectionally related to worse self-reported physical function defined as a continuous (β = -6.27, 95% confidence interval [CI]: -8.48, -4.07) or as a categorical (< 78 vs. ≥ 78) (odds ratio [OR] = 2.10, 95% CI: 1.48, 2.98) outcome. Antidepressant use at WHI enrollment was also associated with worse performance-based physical function (SPPB) [< 10 vs. ≥ 10] (OR = 1.53, 95% CI: 1.05, 2.21) at the 2012-2013 WHI-LLS visit. Compared to non-users, those using sedative/hypnotics at WHI enrollment but not at the 3-year follow-up visit reported a faster decline in physical function between WHI enrollment and follow-up visits. Among postmenopausal women, antidepressant use was cross-sectionally related to worse self-reported physical function, and with worse performance-based physical function after > 20 years of follow-up. Complex relationships found for hypnotic/sedatives were unexpected and necessitate further investigation.
为了研究绝经后精神药物与身体功能的横断面和纵向关系。分析涉及 4557 名妇女健康倡议长寿研究（WHI-LLS）参与者（WHI 登记时的平均年龄（1993-1998 年）：62.8 岁）。抗抑郁药、抗焦虑药和镇静/催眠药在 WHI 登记时和 3 年随访时进行了评估。身体功能的基于表现的评估[短体物理表现电池（SPPB）]在 2012-2013 WHI-LLS 访问时进行。自我报告的身体功能[RAND-36]在 WHI 登记时和最后一次可获得的随访访问时进行了检查-平均 22 [±2.8]（范围：12-27）年后登记。多变量回归模型控制了社会人口统计学、生活方式和健康特征。抗焦虑药与身体功能无关。在 WHI 登记时，抗抑郁药的使用与自我报告的身体功能较差有关，这种功能定义为连续的（β=-6.27，95%置信区间[CI]：-8.48，-4.07）或分类的（<78 与≥78）（比值比[OR]=2.10，95%CI：1.48，2.98）结果。抗抑郁药的使用在 WHI 登记时也与表现较差有关基于的身体功能（SPPB）<10 与≥10]（OR=1.53，95%CI：1.05，2.21）在 2012-2013 WHI-LLS 访问时。与非使用者相比，那些在 WHI 登记时使用镇静/催眠药但不在 3 年随访时使用的人，在 WHI 登记和随访之间，身体功能下降更快。在绝经后妇女中，抗抑郁药的使用与自我报告的身体功能较差有关，并且在 20 多年的随访后，与基于表现的身体功能较差有关。对于催眠/镇静剂的复杂关系出乎意料，需要进一步研究。
