We did not adjust directly for MCI in our analyses, but APOE-ε4 status likely acted as a proxy for individuals with both depression and early cognitive decline, as APOE is a known genetic risk factor for AD and dementia and has also been linked to depression.18 Notably, some research suggests that long-term SSRI use may slow the progression from MCI to AD.19 While this is only an association, it is worth noting that other SSRIs, such as fluoxetine and paroxetine, did not show a significant association with increased risk after adjusting for related conditions. This evidence concerns the gene APOE and depressive disorder.