INS NYC 2024 Program

Poster	Poster Session 05 Program Schedule 02/15/2024 02:30 pm - 03:45 pm Room: Majestic Complex (Posters 61-120) Poster Session 05: Neuropsychiatry \| Addiction/Dependence \| Stress/Coping \| Emotional/Social Processes Final Abstract #76 Use of Psychotropic Medications May Predict Cognitive Decline Over Time in Patient’s MMSE Score Brett Montgomery, Pickup Family Neurosciences Institute at Hoag Memorial Hospital Presbyterian, Newport Beach, United States Lauren Bennett, Pickup Family Neurosciences Institute at Hoag Memorial Hospital Presbyterian, Newport Beach, United States Ruth Morin, Pickup Family Neurosciences Institute at Hoag Memorial Hospital Presbyterian, Newport Beach, United States Category: Neuropsychiatry/Psychopharmacology Keyword 1: memory disorders Keyword 2: psychopharmacology Keyword 3: quality of life Objective: Psychotropic medications are commonly prescribed to individuals with dementia to mitigate behavior and mood symptoms, such as restlessness, agitation, aggression, and insomnia. There is mounting evidence that long term use of certain psychotropic medications may be associated with a faster rate of cognitive decline. The current study seeks to examine the longitudinal impact of psychotropic medications on cognitive functioning, as measured by performance on the Mini-Mental State Exam (MMSE) over approximately 18 months by comparing the performance of individuals taking psychotropic medications to the performance of individuals that are not. The impact of medication classes (e.g., antidepressants, antipsychotics, benzodiazepines) is also explored. Participants and Methods: The study cohort consisted of 659 individuals drawn from the Alzheimer’s Disease Neuroimaging Initiative (ADNI) database who underwent brief cognitive screening via the MMSE at baseline and at their 18-month follow-up. A total of 281 individuals from the study cohort were identified as taking psychotropic medications at baseline. Those taking psychotropic medications were compared to those who were not using a paired samples t-test to assess differences in cognitive decline between baseline and 18-month follow up across the two groups. Additionally, a correlational analysis was conducted to assess whether there was a relationship between psychotropic medication use and cognitive changes. Finally, separate simple linear regressions were conducted to evaluate if medication class (e.g., antidepressants, antipsychotics, benzodiazepines) were predictive of cognitive decline. Results: MMSE scores at the 18-month follow-up were significantly lower than MMSE scores at baseline for individuals taking psychotropic medications versus those who were not (t₍₆₅₈₎ = 13.089, 95% CI [1.51, 2.04], p < 0.001). Additionally, there was a significant correlation between medication status (e.g., whether a patient was taking psychotropic medications) and reduction in MMSE scores over time such that individuals taking psychotropic medications had a lower MMSE score at follow up (χ²₍₂₂₎ = 35.672, Cramer’s V = 0.233, p = 0.033). When looking at cognitive decline over time by antidepressants (F_{(1, 657)}= 13.406, p < 0.0001, R² = 0.020) and antipsychotics (F_(1,657)= 5.527, p = 0.019, R² = 0.008) were found to be predictive of cognitive decline. Conclusions: Use of psychotropic medications was observed to be correlated with accelerated cognitive decline when compared to individuals not on psychotropic medications, as evidenced by declining MMSE scores. Therefore, ensuring individuals and their families are provided adequate information regarding potential risks and side effects before being prescribed psychotropic medications is imperative. Providing patients with compensatory strategies and resources to bolster their cognitive reserves (e.g., cognitive remediation, increase physical and social activity) may be an option to slow decline and increase quality of life. Additionally, consideration for non-pharmacological evidenced based interventions targeting mood symptoms (e.g., Cognitive Behavioral Therapy) should be explored. Further studies assessing these resources as protective factors when patients are prescribed psychotropic medications should be investigated.

Poster

02/15/2024
02:30 pm - 03:45 pm
Room: Majestic Complex (Posters 61-120)

Poster Session 05: Neuropsychiatry | Addiction/Dependence | Stress/Coping | Emotional/Social Processes

Final Abstract #76

Use of Psychotropic Medications May Predict Cognitive Decline Over Time in Patient’s MMSE Score

Brett Montgomery, Pickup Family Neurosciences Institute at Hoag Memorial Hospital Presbyterian, Newport Beach, United States
Lauren Bennett, Pickup Family Neurosciences Institute at Hoag Memorial Hospital Presbyterian, Newport Beach, United States
Ruth Morin, Pickup Family Neurosciences Institute at Hoag Memorial Hospital Presbyterian, Newport Beach, United States

Category: Neuropsychiatry/Psychopharmacology

Keyword 1: memory disorders
Keyword 2: psychopharmacology
Keyword 3: quality of life

Objective:

Psychotropic medications are commonly prescribed to individuals with dementia to mitigate behavior and mood symptoms, such as restlessness, agitation, aggression, and insomnia. There is mounting evidence that long term use of certain psychotropic medications may be associated with a faster rate of cognitive decline. The current study seeks to examine the longitudinal impact of psychotropic medications on cognitive functioning, as measured by performance on the Mini-Mental State Exam (MMSE) over approximately 18 months by comparing the performance of individuals taking psychotropic medications to the performance of individuals that are not. The impact of medication classes (e.g., antidepressants, antipsychotics, benzodiazepines) is also explored.

Participants and Methods:

The study cohort consisted of 659 individuals drawn from the Alzheimer’s Disease Neuroimaging Initiative (ADNI) database who underwent brief cognitive screening via the MMSE at baseline and at their 18-month follow-up. A total of 281 individuals from the study cohort were identified as taking psychotropic medications at baseline. Those taking psychotropic medications were compared to those who were not using a paired samples t-test to assess differences in cognitive decline between baseline and 18-month follow up across the two groups. Additionally, a correlational analysis was conducted to assess whether there was a relationship between psychotropic medication use and cognitive changes. Finally, separate simple linear regressions were conducted to evaluate if medication class (e.g., antidepressants, antipsychotics, benzodiazepines) were predictive of cognitive decline.

Results:

MMSE scores at the 18-month follow-up were significantly lower than MMSE scores at baseline for individuals taking psychotropic medications versus those who were not (t₍₆₅₈₎ = 13.089, 95% CI [1.51, 2.04], p < 0.001). Additionally, there was a significant correlation between medication status (e.g., whether a patient was taking psychotropic medications) and reduction in MMSE scores over time such that individuals taking psychotropic medications had a lower MMSE score at follow up (χ²₍₂₂₎ = 35.672, Cramer’s V = 0.233, p = 0.033). When looking at cognitive decline over time by antidepressants (F_{(1, 657)}= 13.406, p < 0.0001, R² = 0.020) and antipsychotics (F_(1,657)= 5.527, p = 0.019, R² = 0.008) were found to be predictive of cognitive decline.

Conclusions:

Use of psychotropic medications was observed to be correlated with accelerated cognitive decline when compared to individuals not on psychotropic medications, as evidenced by declining MMSE scores. Therefore, ensuring individuals and their families are provided adequate information regarding potential risks and side effects before being prescribed psychotropic medications is imperative. Providing patients with compensatory strategies and resources to bolster their cognitive reserves (e.g., cognitive remediation, increase physical and social activity) may be an option to slow decline and increase quality of life. Additionally, consideration for non-pharmacological evidenced based interventions targeting mood symptoms (e.g., Cognitive Behavioral Therapy) should be explored. Further studies assessing these resources as protective factors when patients are prescribed psychotropic medications should be investigated.