Associated mortality risk of atypical antipsychotic medication in individuals with dementia

作     者：Peter Phiri Tomas Engelthaler Hannah Carr Gayathri Delanerolle Clive Holmes Shanaya Rathod 

作者机构：Research&Innovation DepartmentSouthern Health NHS Foundation TrustSouthampton SO303JBUnited Kingdom Primary CarePopulation Sciences and Medical EducationFaculty of MedicineUniversity of SouthamptonSouthampton SO165STUnited Kingdom Oxford Centre for InnovationAkrivia HealthOxford OX1 BYUnited Kingdom Department of PsychologyUniversity of SouthamptonSouthampton SO165STUnited Kingdom Nuffield Department of Primary Care Health SciencesUniversity of OxfordOxford OX26GGUnited Kingdom Clinical and Experimental SciencesUniversity of SouthamptonSouthampton SO165STUnited Kingdom Research&Innovation DepartmentMemory Assessment&Research CentreSouthern Health NHS Foundation TrustSouthampton SO303JBUnited Kingdom 

出 版 物：《World Journal of Psychiatry》 (世界精神病学杂志)

年 卷 期：2022年第12卷第2期

页      面：298-307页

核心收录：

学科分类：1002[医学-临床医学] 100203[医学-老年医学] 10[医学] 

基　　金：Southern Health NHS Foundation Trust 

主　　题：Dementia Antipsychotics Mortality Vascular Alzheimer’s disease Frontotemporal dementia Lewy bodies Parkinson’s and mixed 

摘      要：BACKGROUND Antipsychotic medications such as risperidone,olanzapine and aripiprazole are used to treat psychological and behavioural symptoms among dementia *** evidence indicate prescription rates for antipsychotics vary and wider consensus to evaluate clinical epidemiological outcomes is *** To investigate the potential impact of atypical antipsychotics on the mortality of patients with *** A retrospective clinical cohort study was developed to review United Kingdom Clinical Record Interactive Search system based data between January 1,2013 to December 31,2017.A descriptive statistical method was used to analyse the *** Mental State Examination(MMSE)scores were used to assess the severity and stage of disease progression.A cox proportional hazards model was developed to evaluate the relationship between survival following diagnosis and other *** A total of 1692 patients were identified using natural language processing of which,587 were prescribed olanzapine,quetiapine or risperidone(common group)whilst 893(control group)were not prescribed any *** prescribed olanzapine showed an increased risk of death[hazard ratio(HR)=1.32;95%confidence interval(CI):1.08-1.60;P0.01],as did those with risperidone(HR=1.35;95%CI:1.18-1.54;P0.001).Patients prescribed quetiapine showed no significant association(HR=1.09;95%CI:0.90-1.34;P=0.38).Factors associated with a lower risk of death were:High MMSE score at diagnosis(HR=0.72;95%CI:0.62-0.83;P0.001),identifying as female(HR=0.73;95%CI:0.64-0.82;P0.001),and being of a White-British ethnic group(HR=0.82;95%CI:0.72-0.94;P0.01).CONCLUSION A significant mortality risk was identified among those prescribed olanzapine and risperidone which contradicts previous findings although the study designs used were *** research should be conducted to better assess clinical epidemiological outcomes associated with diagnosis and therapies to improve c