Evidence map›Paper›PMID 40188305›Full record

SynthesisDrugs & aging2025

Predictors and Moderators of Hospitalisation and Mortality in People with Dementia Using Antipsychotics: Systematic Review.

Timothy Josh D Tan, Edward C Y Lau, Trong H Le, Christine Y Lu, Sarah N Hilmer, Yun-Hee Jeon, Lee-Fay Low, Edwin C K Tan

Abstract readSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Drugs & aging, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Timothy Josh D TanFaculty of Medicine and Health, The University of Sydney School of Pharmacy, The University of Sydney, Sydney, NSW, 2006, Australia.
Edward C Y LauFaculty of Medicine and Health, The University of Sydney School of Pharmacy, The University of Sydney, Sydney, NSW, 2006, Australia.
Trong H LeFaculty of Medicine and Health, The University of Sydney School of Pharmacy, The University of Sydney, Sydney, NSW, 2006, Australia.
Christine Y LuFaculty of Medicine and Health, The University of Sydney School of Pharmacy, The University of Sydney, Sydney, NSW, 2006, Australia.
Sarah N HilmerFaculty of Medicine and Health, Kolling Institute, The University of Sydney and the Northern Local Health District, Sydney, NSW, Australia.
Yun-Hee JeonSusan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia.
Lee-Fay LowFaculty of Medicine and Health, The University of Sydney School of Health Sciences, The University of Sydney, Sydney, NSW, Australia.
Edwin C K TanFaculty of Medicine and Health, The University of Sydney School of Pharmacy, The University of Sydney, Sydney, NSW, 2006, Australia. edwin.tan@sydney.edu.au.ORCID 0000-0003-2922-8837

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BACKGROUND AND

objectivesAntipsychotics are used to manage behaviours and psychological symptoms of dementia. While antipsychotics have been associated with increased risk of adverse outcomes, factors associated with these outcomes have been understudied. Thus, the aim of this study was to identify factors associated with risk of hospitalisation and mortality in older people living with dementia using antipsychotics.

methodsIn total, four databases (Embase, Medline, PsycINFO and Web of Science) were searched from 2010 to 30 April 2024 using keywords and Medical Subject Heading (MeSH) terms related to dementia, older adults, antipsychotics and outcomes (hospitalisation or mortality). Studies including older adults (≥ 65 years) with dementia and extractable data on risk measures were eligible. Risk of bias was assessed using the Joanna Briggs Institute's critical appraisal tools and narrative synthesis of results was performed.

resultsOf the 4139 studies identified, 24 were included (Total N [patients] = 587,885) with the majority being cohort studies (N = 23). Antipsychotic-related factors associated with mortality risk included the type of antipsychotic (e.g. typical versus atypical, adjusted hazards ratio [aHR] 1.50, 95% confidence interval [CI] 1.10, 2.10), and dose (high versus low, relative increases ranging from 57 to 155%). Patient-related factors included age (aHR 1.05, 95% CI 1.01, 1.08) and concomitant use of medications (e.g. benzodiazepines, aHR 2.19, 95% CI 1.83, 2.63). Antipsychotic-related factors associated with hospitalisation risk included the type of antipsychotic (e.g. atypical verus typical, aHR 1.17, 95% CI 1.08, 1.27) and dose (high versus low, adjusted odds ratio [aOR] 1.19, 95% CI 1.09, 1.31). Patient-related factors included concomitant benzodiazepine use (aHR 1.55, 95% CI 1.29, 1.86), and new use compared with past use (aOR 3.07, 95% CI 2.84, 3.32).

conclusionsThis review identified several factors associated with risks of hospitalisation and mortality in antipsychotic users with dementia. Clinicians should consider these risk factors when prescribing antipsychotics to people living with dementia.

Indexed as

Antipsychotic AgentsDementiaHospitalizationAgedHumansRisk FactorsAntipsychotic Agents

Identifiers

PMID40188305
PMCPMC12052867

What Socratic holds

Textmetadata
LicenceCC BY-NC
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.