title: The impact of antipsychotics and neuropsychiatric symptoms on the quality of life of people with dementia living in nursing homes.
abstract: OBJECTIVE
  This study aimed to establish whether antipsychotic (AP) use in patients with dementia negatively affects quality of life (QoL) independent of neuropsychiatric symptoms (NPS).
  
  
  METHODS
  We tested 290 patients with dementia living in nine nursing homes throughout the Netherlands in a longitudinal study. The measurements were repeated every 6 months over 2 years. We studied the change in NPS and AP use and their effect on QoL over time in two separate generalized estimating equations. We assessed QoL and NPS using the Qualidem questionnaire and the Neuropsychiatric Inventory-Nursing Home Version (NPI-NH), respectively.
  
  
  RESULTS
  Antipsychotic prescriptions did not significantly change participant QoL, whereas NPI-NH total score changes consistently predicted changes in QoL. According to the Qualidem, the development of QoL in patients who chronically used APs did not differ from AP-free patients, except on the restless tense behavior subscale. AP-free patients' "restless tense behavior" improved compared with patients who chronically used APs, who showed a slight deterioration in these symptoms; however, this effect did not significantly influence total QoL.
  
  
  CONCLUSIONS
  Antipsychotic use does not necessarily have detrimental effects on the QoL of patients with dementia; rather, NPS consistently and negatively affects QoL. The use of APs to treat NPS is justified when used carefully (i.e., their benefits and side effects should be monitored).
authors.affiliation: Department of Primary and Community Care, Center for Family Medicine, Geriatric Care and Public Health, Alzheimer Center Nijmegen, Radboud University Nijmegen, Medical Center, Nijmegen, The Netherlands. marco.en.yulia@home.nl
authors.forename: Julia
authors.initials: J
authors.lastname: van de Ven-Vakhteeva
authors.forename: Hans
authors.initials: H
authors.lastname: Bor
authors.forename: Roland B
authors.initials: RB
authors.lastname: Wetzels
authors.forename: Raymond T C M
authors.initials: RT
authors.lastname: Koopmans
authors.forename: Sytse U
authors.initials: SU
authors.lastname: Zuidema
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D003704:Dementia / Q000188:drug therapy* / Q000523:psychology; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D009426:Netherlands; D009483:Neuropsychological Tests; D009735:Nursing Homes; D011788:Quality of Life; D011795:Surveys and Questionnaires
chemical_list: D014150:Antipsychotic Agents