title: Older men with dementia are at greater risk than women of serious events after initiating antipsychotic therapy.
abstract: OBJECTIVE
  To understand how drug therapy differently affects older women and men.
  
  
  METHODS
  Population-based, retrospective cohort study.
  
  
  METHODS
  Ontario, Canada.
  
  
  METHODS
  Twenty-one thousand five hundred twenty-six older adults (13,760 women, 7,766 men) with dementia newly started on oral atypical antipsychotic therapy between April 1, 2007, and March 1, 2010.
  
  
  METHODS
  Numbers and rates of serious events. Serious events were defined as a hospital admission or death within 30 days of treatment initiation. Unadjusted and adjusted odds ratios of women and men were compared in the full cohort and in strata based on setting of care, age, Charlson Comorbidity Index (CCI), and antipsychotic dose.
  
  
  RESULTS
  Of 21,526 older adults with a median age of 84, 1,889 (8.8%) had a serious event (1,044 women, 7.6%; 845 men, 10.9%). Of these, 363 women (2.6%) and 355 men (4.6%) died. Men were more likely than women to be hospitalized or die during the 30-day follow-up period (adjusted odds ratio = 1.47, 95% confidence interval = 1.33-1.62) and consistently more likely to experience a serious event in each stratum. A gradient of risk according to drug dose was found for the development of a serious event in women and men.
  
  
  CONCLUSIONS
  The risk of developing a serious event shortly after the initiation of antipsychotic therapy was high in women and men with dementia but was consistently higher in older men. This pattern remained the same in strata based on setting of care, age, CCI, and antipsychotic dose.
authors.affiliation: Women's College Research Institute, Women's College Hospital, Toronto, Ontario, Canada. paula.rochon@wchospital.ca
authors.forename: Paula A
authors.initials: PA
authors.lastname: Rochon
authors.forename: Andrea
authors.initials: A
authors.lastname: Gruneir
authors.forename: Sudeep S
authors.initials: SS
authors.lastname: Gill
authors.forename: Wei
authors.initials: W
authors.lastname: Wu
authors.forename: Hadas D
authors.initials: HD
authors.lastname: Fischer
authors.forename: Susan E
authors.initials: SE
authors.lastname: Bronskill
authors.forename: Sharon-Lise T
authors.initials: SL
authors.lastname: Normand
authors.forename: Peter C
authors.initials: PC
authors.lastname: Austin
authors.forename: Dallas P
authors.initials: DP
authors.lastname: Seitz
authors.forename: Chaim M
authors.initials: CM
authors.lastname: Bell
authors.forename: Longdi
authors.initials: L
authors.lastname: Fu
authors.forename: Lorraine
authors.initials: L
authors.lastname: Lipscombe
authors.forename: Geoffrey M
authors.initials: GM
authors.lastname: Anderson
authors.forename: Jerry H
authors.initials: JH
authors.lastname: Gurwitz
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D014150:Antipsychotic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D016001:Confidence Intervals; D003704:Dementia / Q000188:drug therapy* / Q000453:epidemiology; D004630:Emergencies / Q000453:epidemiology*; D005260:Female; D005500:Follow-Up Studies; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D016017:Odds Ratio; D009864:Ontario / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors
chemical_list: D014150:Antipsychotic Agents