Pre-COVID-19 psychotropic medication use linked to higher rate of dementia

The findings of a study published in Frontiers in Medicine suggest that the use of psychotropic medications in older adults hospitalised with COVID-19 increases the 1-year incidence of post-COVID dementia.

The retrospective cohort study used data from Northwell Health, a large integrated academic health system in New York. The association between pre-COVID psychotropic medication use and 1-year incidence of dementia was examined in 1755 elderly patients hospitalised with a COVID-19 infection.

The 1-year incidence rate of post-COVID dementia was 12.7% (n = 223). There were significant associations between a greater 1-year incidence of post-COVID dementia and pre-COVID psychotropic medications (odds ratio [OR] 2.7 [95% CI 1.8, 4.0]; p < 0.001) and delirium (OR 3.0 [1.9, 4.6]; p < 0.001). The association between psychotropic medications and incident dementia remained when restricting the analysis to patients with ≥1 neurological or psychiatric diagnosis at the time of COVID-19 admission (OR 3.09 [1.5, 6.6]; p < 0.01). The greatest association with post-COVID dementia was seen for antipsychotics (OR 2.8 [1.7, 4.4]; p < 0.001) and mood stabilisers/anticonvulsants (OR 2.4 [1.39, 4.02]; p = 0.001). Random Forest and LASSO1 analyses confirmed the association of psychotropic medication with dementia.

"Psychotropic medications may be risk markers that signify neuropsychiatric symptoms during prodromal dementia, and not mutually exclusive, contribute to post-COVID dementia", conclude the authors.