Antidepressants and risk of pneumonia in older adults: a nationwide self-controlled case series

Jinyoung Jeon; Min Jung Geum; Young-Mi Ah; Hyun Woo Lee; Yun Mi Yu

doi:10.1093/ageing/afag070

journal article Apr 01, 2026

Antidepressants and risk of pneumonia in older adults: a nationwide self-controlled case series

Jinyoung Jeon Min Jung Geum Young-Mi Ah Hyun Woo Lee Yun Mi Yu

Age and Ageing Vol. 55 No. 4 · Oxford University Press (OUP)

View at Publisher Save 10.1093/ageing/afag070

Abstract

Abstract

Background
Pneumonia is a leading cause of morbidity and mortality in older adults, and antidepressant use is increasing globally. Although biologically plausible links exist, comprehensive, population-based evidence remains limited. We evaluated the association of antidepressant use with pneumonia hospitalisation and potential effect modifiers.

Methods
We conducted a nationwide self-controlled case series using Korea National Health Insurance Service–Senior Cohort data on adults aged 60–80 years who initiated antidepressants and were hospitalised for pneumonia (2008–2019). The risk period was defined as 90 days (three 30-day intervals) after antidepressant initiation, with baseline periods as the reference. Incidence rate ratios (IRRs) were calculated using conditional Poisson regression adjusted for age and season. Subgroup analyses were performed according to demographics, comorbidities, and the anticholinergic/sedative burden.

Results
Among 15,478 individuals, pneumonia hospitalisation risk was higher during the 90-day risk period (IRR 2.48, 95% CI 2.35–2.61), peaking in the first 30 days (IRR 3.53, 95% CI 3.31–3.76). Risk remained elevated in later intervals and declined during washout. Stronger associations were observed in older age and neurologic comorbidities. A graded pattern by pharmacological burden showed the highest risk in those with both high anticholinergic and sedative loads.

Conclusion
Antidepressant use was associated with an increased pneumonia hospitalisation in older adults. The risk was further elevated in patients with neurologic conditions or a high anticholinergic/sedative burden, highlighting the need for individualised prescriptions and routine medication reviews.

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Details

Published: Apr 01, 2026
Vol/Issue: 55(4)
License: View

Authors

J

Jinyoung Jeon

Department of Pharmaceutical Medicine and Regulatory Science, Yonsei University Colleges of Medicine and Pharmacy , Incheon 21983 ,; Department of Pharmacy, National Cancer Center Hospital, Goyang-si 10408 ,

M

Min Jung Geum

College of Pharmacy and Institute of Pharmaceutical Science and Technology, Hanyang University , Ansan-si, Gyeonggi-do 15588 ,

Y

Young-Mi Ah

College of Pharmacy, Yeungnam University , Gyeongsan-si 38541 ,

H

Hyun Woo Lee

Department of Pharmaceutical Medicine and Regulatory Science, Yonsei University Colleges of Medicine and Pharmacy , Incheon 21983 ,

Y

Yun Mi Yu

Department of Pharmaceutical Medicine and Regulatory Science, Yonsei University Colleges of Medicine and Pharmacy , Incheon 21983 ,; Department of Pharmacy and Yonsei Institute of Pharmaceutical Sciences, Yonsei University College of Pharmacy , Incheon 21983 ,

Cite This Article

Jinyoung Jeon, Min Jung Geum, Young-Mi Ah, et al. (2026). Antidepressants and risk of pneumonia in older adults: a nationwide self-controlled case series. Age and Ageing, 55(4). https://doi.org/10.1093/ageing/afag070

Antidepressants and risk of pneumonia in older adults: a nationwide self-controlled case series

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