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Short term use of antipsychotics increases the risk of serious adverse events in elderly people with dementia

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QUESTION

Question:

Do antipsychotics increase the risk of serious adverse events in elderly people with dementia?

People:

20 682 people living in the community and 20 559 nursing home residents with a diagnosis of dementia (ICD-9 and ICD-10) and >65 years of age. All eligible individuals resident in Ontario between 1 April 1997 and 31 March 2004 were identified and their prescription data for this period obtained. Three equally sized matched groups within the community and nursing home cohorts were selected using propensity matching: atypical antipsychotic use, conventional antipsychotic use and no antipsychotic but at least one other medication prescribed (control group). Each group in the community cohort consisted of 6894 people and each group in the nursing home residents’ cohort had 6853 members. The matched groups were similar in demographic and clinical characteristics. Exclusions: history of schizophrenia, Huntington’s disease, tics, dialysis, extrapyramidal symptoms, parkinsonism, trauma, hip/pathological fractures during 5 years prior to index prescription and those who had received palliative care prior to death. …

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