Psychotropic Medication Use Is Associated With Greater 1-Year Incidence of Dementia After COVID-19 Hospitalization

作者：Yun Freudenberg‐Hua, Alexander Makhnevich, Wentian Li, Yan Liu, Michael Qiu, Allison Marziliano, Maria Torroella Carney, Blaine Greenwald, John M. Kane, Michael A. Diefenbach, Edith Burns, Jeremy Koppel, Liron Sinvani · 发表于：Frontiers in Medicine · 年份：2022 · DOI：10.3389/fmed.2022.841326 · 被引用次数：9 · 研究领域：Long-Term Effects of COVID-19、Pharmacological Receptor Mechanisms and Effects、Intensive Care Unit Cognitive Disorders

Background COVID-19 has been associated with an increased risk of incident dementia (post-COVID dementia). Establishing additional risk markers may help identify at-risk individuals and guide clinical decision-making. Methods We investigated pre-COVID psychotropic medication use (exposure) and 1-year incidence of dementia (outcome) in 1,755 patients (≥65 years) hospitalized with COVID-19. Logistic regression models were used to examine the association, adjusting for demographic and clinical variables. For further confirmation, we applied the Least Absolute Shrinkage and Selection Operator (LASSO) regression and a machine learning (Random Forest) algorithm. Results One-year incidence rate of post-COVID dementia was 12.7% ( N = 223). Pre-COVID psychotropic medications (OR = 2.7, 95% CI: 1.8–4.0, P < 0.001) and delirium (OR = 3.0, 95% CI: 1.9–4.6, P < 0.001) were significantly associated with greater 1-year incidence of post-COVID dementia. The association between psychotropic medications and incident dementia remained robust when the analysis was restricted to the 423 patients with at least one documented neurological or psychiatric diagnosis at the time of COVID-19 admission (OR = 3.09, 95% CI: 1.5–6.6, P = 0.002). Across different drug classes, antipsychotics (OR = 2.8, 95% CI: 1.7–4.4, P < 0.001) and mood stabilizers/anticonvulsants (OR = 2.4, 95% CI: 1.39–4.02, P = 0.001) displayed the greatest association with post-COVID dementia. The association of ps...