Evidence map›Paper›PMID 39828241›Full record

ArticleJournal of the American Medical Directors Association2025

Antipsychotic Use in Older Adults with Dementia: Community and Nursing Facility Trends in Texas, 2015-2020.

Youngran Kim, Trudy M Krause, Rafael Samper-Ternent, Antonio L Teixeira

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of the American Medical Directors Association, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  2. Review
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Youngran KimDepartment of Management, Policy and Community Health, School of Public Health, The University of Texas Health Science Center at Houston, Houston, TX, USA; Center for Health Care Data, School of Public Health, The University of Texas Health Science Center at Houston, Houston, TX, USA. Electronic address: Youngran.Kim@uth.tmc.edu.
Trudy M KrauseDepartment of Management, Policy and Community Health, School of Public Health, The University of Texas Health Science Center at Houston, Houston, TX, USA; Center for Health Care Data, School of Public Health, The University of Texas Health Science Center at Houston, Houston, TX, USA.
Rafael Samper-TernentDepartment of Management, Policy and Community Health, School of Public Health, The University of Texas Health Science Center at Houston, Houston, TX, USA; Institute on Aging, The University of Texas Health Science Center at Houston, Houston, TX, USA.
Antonio L TeixeiraThe Gleen Biggs Institute for Alzheimer's & Neurodegenerative Diseases, The University of Texas Health Science Center at San Antonio, San Antonio, TX, USA.

Funding

Determining the Utilization, Cost, and Safety of Antipsychotics Among the Elderly with Dementia Post-Brexpiprazole Approval for Agitation in Alzheimer's DiseaseR21AG091282 · NIA · UNIVERSITY OF TEXAS HLTH SCI CTR HOUSTON · PI KIM, YOUNGRAN, TEIXEIRA, ANTONIO LUCIO · 2025 to 2025
$444k
NIA NIH HHS R21 AG091282
6 · The paper itself

Abstract

objectivesTo assess recent trends in antipsychotic use among older adults with Alzheimer's disease and related dementias (ADRDs) according to their residential status and determine the factors associated with the use of antipsychotics.

designPopulation-based, cross-sectional study using Texas Medicare Fee-for-Service data. SETTING AND

participantsIndividuals aged ≥ 65 years with ADRDs who had at least 3 months of Medicare Part A and B, and Part D for prescription drug coverage, in any year between 2015 and 2020.

methodsTemporal trends for antipsychotic use were reported by calendar year, and the associations between antipsychotic use and potential predictors were assessed overall and by residential status.

resultsAmong an annual average of 161,848 older adults with ADRDs (median age, 82 years; 64.8% female), overall antipsychotic use decreased by 25.8%, from 14.5% in 2015 to 10.8% in 2020. The decline was primarily observed among those with any nursing facility (NF) residence, where use dropped from 22.1% to 12.4%, whereas community-dwelling individuals maintained a steady rate of approximately 10%. Factors associated with increased antipsychotic use included male sex, Black and Hispanic individuals, dual eligibility, Alzheimer's disease (non-Alzheimer's disease), emergency department visits, hospitalization, depression, and anxiety disorders. However, these associations varied across residential statuses. Older age was more strongly associated with decreased antipsychotic use among those with NF residence than those in the community. Compared with white individuals, Black individuals were more likely to receive antipsychotics in the community, whereas Hispanic and Asian individuals were more likely to receive antipsychotics among those with NF residence. CONCLUSIONS AND IMPLICATIONS: Although antipsychotic use substantially decreased among those with NF residence, it remained steady among community-dwelling individuals. Given that two-thirds of individuals with dementia reside in the community, more attention is needed to understand antipsychotic use in this population.

Indexed as

Antipsychotic AgentsDementiaNursing HomesAgedAged, 80 and overCross-Sectional StudiesFemaleHumansIndependent LivingMaleMedicareTexasUnited StatesAntipsychotic AgentsAntipsychoticscommunity-dwellingdementiaMedicareoff-label antipsychotics

Identifiers

PMID39828241
PMCPMC12962824

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Registered trials

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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.