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Cited by 624Dementia and Cognitive Impairment ResearchPharmaceutical Practices and Patient OutcomesSchizophrenia research and treatment

The DOI matches its Crossref record; 65 of the 66 references it cites were found in a registry or an index.

Antipsychotic Drug Use and Mortality in Older Adults with Dementia

Gill, Sudeep S., Bronskill, Susan E., Normand, Sharon-Lise T., Anderson, Geoffrey M., Sykora, Kathy, Lam, Kelvin, Bell, Chaim M., Lee, Philip E., Fischer, Hadas D., Herrmann, Nathan, Gurwitz, Jerry H., Rochon, Paula A.·2007·Annals of Internal Medicine
DOI 10.7326/0003-4819-146-11-200706050-00006
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Abstract

BACKGROUND: Antipsychotic drugs are widely used to manage behavioral and psychological symptoms in dementia despite concerns about their safety. OBJECTIVE: To examine the association between treatment with antipsychotics (both conventional and atypical) and all-cause mortality. DESIGN: Population-based, retrospective cohort study. SETTING: Ontario, Canada. PATIENTS: Older adults with dementia who were followed between 1 April 1997 and 31 March 2003. MEASUREMENTS: The risk for death was determined at 30, 60, 120, and 180 days after the initial dispensing of antipsychotic medication. Two pairwise comparisons were made: atypical versus no antipsychotic use and conventional versus atypical antipsychotic use. Groups were stratified by place of residence (community or long-term care). Propensity score matching was used to adjust for differences in baseline health status. RESULTS: A total of 27,259 matched pairs were identified. New use of atypical antipsychotics was associated with a statistically significant increase in the risk for death at 30 days compared with nonuse in both the community-dwelling cohort (adjusted hazard ratio, 1.31 [95% CI, 1.02 to 1.70]; absolute risk difference, 0.2 percentage point) and the long-term care cohort (adjusted hazard ratio, 1.55 [CI, 1.15 to 2.07]; absolute risk difference, 1.2 percentage points). Excess risk seemed to persist to 180 days, but unequal rates of censoring over time may have affected these results. Relative to atypical antipsychotic use, conventional antipsychotic use was associated with a higher risk for death at all time points. Sensitivity analysis revealed that unmeasured confounders that increase the risk for death could diminish or eliminate the observed associations. LIMITATIONS: Information on causes of death was not available. Many patients did not continue their initial treatments after 1 month of therapy. Unmeasured confounders could affect associations. CONCLUSIONS: Atypical antipsychotic use is associated with an increased risk for death compared with nonuse among older adults with dementia. The risk for death may be greater with conventional antipsychotics than with atypical antipsychotics.

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Research works printed but not linked: 4

  1. Levy AR, 2003, Can J Clin Pharmacol, 10, 67
  2. 10.1080/00031305.1985.10479383 · DOI
  3. Trifirò G, 2006, Pharmacoepidemiol Drug Saf
  4. Gill SS, 2006, JAMA, 295, 495

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Metadata

Authors
Gill, S. S., Bronskill, S. E., Normand, S.-L. T., Anderson, G. M., Sykora, K., Lam, K., Bell, C. M., Lee, P. E., Fischer, H. D., Herrmann, N., Gurwitz, J. H., & Rochon, P. A.
Affiliations
  • Harvard University (US)
  • From Queen's University, Kingston, Ontario, Canada; Institute for Clinical Evaluative Sciences and University of Toronto, Toronto, Ontario, Canada; Harvard Medical School and Harvard School of Public Health, Boston, Massachusetts; University of British Columbia, Vancouver, British Columbia, Canada; and Meyers Primary Care Institute of the University of Massachusetts Medical School, Fallon Clinic Foundation, and Fallon Community Health Plan, Worcester, Massachusetts.
ORCID
Venue
Annals of Internal Medicine
Publisher
American College of Physicians
Published
2007-06-05
Volume
146
Issue
11
Pages
775-786
ISSN
  • 0003-4819 (ISSN-L)
  • 1539-3704
DOI
10.7326/0003-4819-146-11-200706050-00006
OpenAlex
W2144855317
Cited by
624
References
66
Citations by year
2026: 12 · 2025: 24 · 2024: 17 · 2023: 22 · 2022: 30 · 2021: 18 · 2020: 27 · 2019: 31 · 2018: 38 · 2017: 36 · 2016: 45 · 2015: 42 · 2014: 30 · 2013: 37 · 2012: 35
FWCI
26.16
Type
journal article
Language
en
Open access
closed
Licence
www.acpjournals.org/journal/aim/text-and-data-mining (tdm)
Locations
  • Annals of Internal Medicine (publishedVersion)
  • PubMed (publishedVersion)
  • eScholarship@UMassChan (submittedVersion)
Topics
  • Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
  • Health Sciences › Medicine › Geriatrics and Gerontology › Pharmaceutical Practices and Patient Outcomes
  • Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
Keywords
antipsychotic drugs, atypical antipsychotics, typical antipsychotics, dementia, all-cause mortality, older adults, behavioral and psychological symptoms of dementia, long-term care, community-dwelling older adults, drug safety
MeSH terms
Aged, Aged, 80 and over, Dementia, Female, Humans, Male, Ontario, Sensitivity and Specificity, Time Factors, Antipsychotic Agents, Matched-Pair Analysis, Risk Assessment

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