title: Association between Antipsychotic Drugs and Mortality in Older Persons with Alzheimer's Disease: A Systematic Review and Meta-Analysis.
abstract: Antipsychotic drugs have been inconsistently associated with death risk of Alzheimer's disease (AD) patients. Herein we review and quantitatively summarize the evidence from epidemiological studies. Pertinent studies were identified by searching PubMed and Cochrane Library Register of Controlled Trials through 20 December 2015. The DerSimonian and Laird random effect model was adopted as the pooling method. Twelve studies from nine articles with 11,463 participants were included. The pooled RR of observational studies was 1.36 (95% CI, 0.83-2.24; I2 = 94.9%) for antipsychotic drugs users versus individuals who were not exposed to antipsychotic drugs. When the three studies that were key contributors to the high heterogeneity were excluded, the pooled RR was 2.08 (95% CI 1.39 to 3.13). The result of one double-blind randomized clinical trial indicated that antipsychotic drugs nearly doubled the risk of death in AD patients. In conclusion, there is no evidence of absence of association between antipsychotic drugs' use with death risk of AD patients. Careful assessments of potential benefits and risks should be made before prescribing antipsychotics for treatment of psychosis symptoms and behavioral problems of AD patients.
authors.affiliation: Department of Chronic Noncommunicable Diseases, Qingdao Municipal Centers for Disease Control and Prevention, Qingdao, China.
authors.forename: Yaoming
authors.initials: Y
authors.lastname: Zhai
authors.affiliation: Department of Social Prevention and Control, Qingdao Mental Health Center, Qingdao, China.
authors.forename: Song
authors.initials: S
authors.lastname: Yin
authors.affiliation: Department of Epidemiology and Health statistics, Qingdao University Medical College, Qingdao, China.
authors.forename: Dongfeng
authors.initials: D
authors.lastname: Zhang
mesh_terms: D000368:Aged; D000544:Alzheimer Disease / Q000188:drug therapy / Q000401:mortality*; D014150:Antipsychotic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D012307:Risk Factors
chemical_list: D014150:Antipsychotic Agents
keywords: Alzheimer’s disease; antipsychotic agents; epidemiology; meta-analysis