People with Alzheimer's disease who used antipsychotic drugs had a higher number of accumulated hospital days than people with Alzheimer's disease who did not use antipsychotics, according to a new study from the University of Eastern Finland. The results were published in the Journal of American Medical Directors Association. During a two-year follow-up, persons who initiated antipsychotic drugs accumulated approximately eleven more hospital days per person-year.
People who initiated an antipsychotic drug accumulated more hospital days than non-initiators due to dementia, mental and behavioural disorders, diseases of the respiratory and genitourinary system, cardiovascular disorders, and different symptoms such as fatigue. In addition, people who initiated an antipsychotic drug had more hospital days due to their caregivers' days off.
All-cause hospitalisations have been suggested to proxy overall drug safety, and therefore the results may partially reflect adverse effects. However, these results also reflect difficulties in the treatment of severe behavioural and psychological symptoms of dementia. Thus, another reason for a higher accumulation of hospital days is the indication behind antipsychotic use.
The study was based on the nationwide register-based MEDALZ cohort that includes all community-dwelling persons with a clinically verified diagnosis of Alzheimer's disease in Finland during 2005-2011 (70,718 people). Data on antipsychotic use was extracted from the Finnish Prescription Register. Comorbidities, concomitant medications and time since AD diagnosis were accounted for in the analyses. The study was conducted at the University of Eastern Finland and funded by the Academy of Finland.
Postdoctoral Researcher Marjaana Koponen, University of Eastern Finland, School of Pharmacy, marjaana.koponen(at)uef.fi
Koponen M, Lavikainen P, Taipale H, Tanskanen A, Tiihonen J, Hartikainen S, Tolppanen AM: Accumulation of hospital days among antipsychotic initiators with Alzheimer's disease. Journal of the American Medical Directors Association. doi: 10.1016/j.jamda.2019.07.009. In press, available online 26 Aug 2019: