All-cause mortality in older adults with affective disorders and dementia under treatment with antipsychotic drugs: A matched-cohort study. (July 2018)

• Record Type: Journal Article
• Authors: Szmulewicz, Alejandro G.; Ferraris, Augusto; Rodriguez, Agustín; Cervera, Lucía Campos; Gonzalez, Macarena Lopez; Man, Federico; Angriman, Federico; Martino, Diego
• Is Part Of: Psychiatry research. Volume 265(2018)
• Page Start: 82
• Page End: 86
• Publication Date: 2018-07
• Subjects: Antipsychotic agents -- Mental health -- Cohort study -- Pharmacoepidemiology -- Older adults; Psychiatry -- Periodicals; Psychiatry -- periodicals; Psychiatrie -- Périodiques; 616.89
• DOI: 10.1016/j.psychres.2018.04.034
• Languages: English
• ISSNs: 0165-1781

Abstract

Highlights: No significant differences in 5-year mortality risk between dementia and affective patients. Closer medical care to elderly with affective disorders using antipsychotics is warranted. Differential effects of underlying condition on mortality cannot be ruled out. Abstract: We aimed to compare the mortality risk between patients with affective disorders and dementia under treatment with antipsychotics. To do this, a matched-cohort study based on an electronic database of a tertiary teaching hospital in Argentina was performed. Antipsychotic exposure was defined as any antipsychotic drug initiated by the patient. Primary outcome was defined as all-cause mortality during the 5-year follow-up period. To estimate the association between baseline diagnosis (affective disorders vs. dementia) and all-cause mortality, we used a multivariate generalized linear model with robust standard errors. Of 1008 eligible patients, 114 age-matched pairs were included in the present study. The primary event occurred in 23 patients (20%) and 17 patients (15%) in the dementia and affective disorder group respectively. In the adjusted model, the risk of all cause mortality for the affective disorders group was 0.92 times the risk for the dementia group (95%CI, 0.54–1.59, p = 0.77). In conclusion, older patients with affective disorders starting antipsychotic treatment presented with a similar risk of all-cause mortality during the 5-year follow-up when compared to older patients with dementia who were also initiating either typical or atypical antipsychotic medications. Closer medical attention to older patients with mental conditions under antipsychotic treatment remains warranted.