ArticleThe journals of gerontology. Series A, Biological sciences and medical sciences2019
Association Between Antipsychotics and All-Cause Mortality Among Community-Dwelling Older Adults.
Article in The journals of gerontology. Series A, Biological sciences and medical sciences, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 3 of them syntheses that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
21 citing papers in PubMed, 3 syntheses or guidelines pooled it, 48 citations in OpenAlex.
- Efficacy and Safety of Cannabinoids for Neuropsychiatric Symptoms of Dementia: A Systematic Review with Meta-analysis.CNS drugs · 2026Pooled it
- Dose-Dependent efficacy and safety of Brexpiprazole in agitation associated with dementia in Alzheimer's disease: A systematic review and meta-analysis.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2026Pooled it
- The consequences of antipsychotic medication use for people living with dementia: a systematic review and meta-analysis.Frontiers in psychiatry · 2026Pooled it
- Association between sedative prescriptions after hospital discharge and falls and other adverse events in older adults: a population-based cohort study.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2026Article
- Disrupting stigma associated with dementia and dance through documentary film.BMC public health · 2026Article
- Shifts in Antipsychotic Prescribing by Clinician Type for Medicare Part D Beneficiaries, 2013-2023.JAMA network open · 2026Article
- Pharmacological management of agitation in dementia: An evidence-based review with expert consensus.Journal of the Chinese Medical Association : JCMA · 2026Review
- The Use of Long-Acting Injectables for People with Schizophrenia: Consensus Panel Recommendations for Overcoming Barriers and Implementing Treatment.Neurology and therapy · 2025Article
- Evaluation of Mortality in Users of Pimavanserin Compared with Other Atypical Antipsychotics in Patients with Parkinson's Disease Psychosis: An Update.Drug safety · 2025Article
- Receipt of Medicare Part D comprehensive medication reviews in older adults with dementia.Journal of managed care & specialty pharmacy · 2025Article
- Multiple adverse outcomes associated with antipsychotic use in people with dementia: population based matched cohort study.BMJ (Clinical research ed.) · 2024Article
- Antipsychotic use among older patients with dementia receiving home health care services: Prevalence, predictors, and outcomes.Journal of the American Geriatrics Society · 2023Article
- The longitudinal patterns of psychotropic drug prescriptions for subpopulations of community-dwelling older people with dementia: electronic health records based retrospective study.BMC primary care · 2023Article
- Cross-Regional Data Initiative for the Assessment and Development of Treatment for Neurological and Mental Disorders.Clinical epidemiology · 2023Article
- Clinical outcomes and treatment patterns of older adults with dementia-related psychosis by dementia type in the United States.BMC geriatrics · 2022Article
- Delusional Severity Is Associated with Abnormal Texture in FLAIR MRI.Brain sciences · 2022Article
- Self-reported sleep characteristics associated with dementia among rural-dwelling Chinese older adults: a population-based study.BMC neurology · 2022Article
- Bipolar depression: a review of treatment options.General psychiatry · 2022Review
- Assessment of the Risk of Antipsychotics in Patients with Dementia in Actual Clinical Practice in Primary Health Care.Pharmaceuticals (Basel, Switzerland) · 2021Article
- Psychosocial Factors Associated with Sleep Quality and Duration Among Older Adults with Chronic Pain.Population health management · 2021Article
Corrections and comments
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Authors and funding
7 authors at 5 institutions in 1 country.
Funding
Abstract
backgroundAntipsychotics are prescribed to treat various symptoms in older adults, however, their safety in this context has not been fully evaluated. The objective was to evaluate mortality risks associated with off-label use of antipsychotics among older adults with no preexisting mental illness or dementia relative to those with diagnosis of dementia.
methodsData (2007-2015) were derived from Department of Veterans Affairs registries for 730,226 patients (≥65 years) with no baseline serious mental illness, dementia). We estimated the cumulative incidence of antipsychotics prescription and 10-year all-cause mortality. The extended Cox models were used to estimate Hazard Ratios (HRs) associated with antipsychotics prescription, adjusted for time-varying covariates, dementia diagnosis, comorbidity index score, and age at time of first exposure to antipsychotics.
resultsThe study included 98% males, 13% African Americans, and 81% Caucasian. Patients with dementia and antipsychotics had the highest risk of mortality (78.0%), followed by (73.0%) for patients with dementia alone and compared with patients without dementia or antipsychotics exposure who had the lowest mortality risk (42.0%). Exposure to typical antipsychotics was associated with (HR: 2.1, confidence interval [CI] 2.0-2.2) compared with atypical antipsychotics (HR: 1.5, CI 1.4-1.5, p = <.0001).
conclusionIn a large cohort of older adults, antipsychotics were associated with an increased risk of all-cause mortality. While significant increase in mortality was attributable to the diagnosis of dementia, the addition of antipsychotics resulted in added mortality risk among all patients. Antipsychotic medications should be used cautiously in all older adults, not only those with dementia.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.