To synthesize current evidence on the consequences of antipsychotic drug use in individuals with dementia, focusing on mortality and other adverse outcomes, while emphasizing the need for cautious prescribing.
Key Findings:
APD use is associated with a significantly increased mortality risk (pooled HR = 1.32; 95% CI 1.12, 1.56).
Similar risk elevation for both typical and atypical APDs.
Higher mortality risks observed among community-dwelling individuals.
Limited and heterogeneous evidence for other adverse outcomes like stroke, pneumonia, and hip fractures.
Interpretation:
The findings highlight the increased mortality risk associated with APD use in dementia patients, necessitating cautious prescribing and regular monitoring, and suggest areas for future research.
Limitations:
High heterogeneity in mortality outcomes (I2 = 98.86%).
Limited evidence for non-fatal adverse outcomes, indicating a need for more comprehensive studies.
Potential biases due to study design and data sources.
Conclusion:
APD use in PwD is linked to increased mortality and may elevate risks for serious non-fatal events, underscoring the need for careful medication management and the importance of non-pharmacological interventions.
