Antipsychotic medication use tied to mortality risk among elders

  • Kheirbek RE & al.
  • J Gerontol A Biol Sci Med Sci
  • 11 Feb 2019

  • curated by Kelli Whitlock Burton
  • Clinical Essentials
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Takeaway

  • The use of antipsychotic medications was associated with an increased risk of all-cause mortality in older adults with and without dementia, including those with no history of mental illness.
  • Dementia significantly increased mortality risk, and antipsychotic medication use raised the risk even higher.

Why this matters

  • Nearly half of study participants with dementia were prescribed an antipsychotic compared with just under 5% of those without dementia.

Study design

  • Data from Department of Veterans Affairs registries on 716,841 community-dwelling adults age ≥65 years with no history of serious mental illness, dementia.
  • Funding: National Institutes of Health.

Key results

  • 1.8% of participants diagnosed with dementia during study period, of which 48.8% were prescribed antipsychotics.
  • Approximately 4.7% of patients not diagnosed with dementia used antipsychotics.
  • Mortality risk was higher with dementia and antipsychotic use (78%), followed by dementia alone (73%), antipsychotic use but no dementia (55%) vs no dementia or antipsychotic use (42%) (P<.0001>
  • Dementia vs no dementia was associated with higher mortality risk (aHR, 2.26; P<.001>
  • Exposure vs nonexposure of typical (aHR, 2.12; P<.001 and atypical p antipsychotics was associated with higher mortality>

Limitations

  • Retrospective study design.
  • Results may not be generalizable to nonveteran groups.

Coauthored with Antara Ghosh, PhD

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