Public Health.

Area of Science:

• Gerontology
• Neuroscience
• Psychiatry

Background:

• Depression is a significant, modifiable risk factor for dementia.
• Previous research on antidepressant use and dementia risk has produced conflicting results.
• Potential confounding or effect modification by sex or frailty may explain discrepancies.

Purpose of the Study:

• To conduct a scoping review of existing literature.
• To determine if studies on antidepressant use and dementia in adults over 55 explored sex or frailty as confounders or effect modifiers.

Main Methods:

• Searched multiple databases (PubMed, MEDLINE, Embase, CINAHL, Cochrane Library).
• Included studies describing participant sex or frailty.
• Revised eligibility criteria during screening due to limited eligible studies.

Main Results:

• Included 21 observational studies after screening over 7800 titles/abstracts.
• No studies explicitly defined or investigated sex or frailty as primary objectives.
• Frailty was not measured or described in any study; sex was inconsistently explored as a confounder and not as an effect modifier.

Conclusions:

• Frailty has not been explored as a confounder or effect modifier in antidepressant-dementia research.
• The role of sex as an effect modifier in the antidepressant-dementia relationship remains unexamined.
• Inconsistencies in methodologies hinder conclusions on sex as a confounder; future research should address frailty, sex/gender beyond binary, and effect modification.