title: Do antipsychotics lead to cognitive impairment in dementia? A meta-analysis of randomised placebo-controlled trials.
abstract: Behavioural and psychological symptoms in dementia (BPSD) are common and often treated with antipsychotics, which are known to have small efficacy and to cause many side effects. One potential side effect might be cognitive decline. We searched MEDLINE, Scopus, CENTRAL and www.ClincalStudyResult.org for randomized, double-blind, placebo-controlled trials using antipsychotics for treating BPSD and evaluated cognitive functioning. The studies identified were summarized in a meta-analysis with the standardized mean difference (SMD, Hedges's g) as the effect size. Meta-regression was additionally performed to identify associated factors. Ten studies provided data on the course of cognitive functioning. The random effects model of the pooled analysis showed a not significant effect (SMD = -0.065, 95 % CI -0.186 to 0.057, I2= 41 %). Meta-regression revealed a significant correlation between cognitive impairment and treatment duration (R2= 0.78, p < 0.02) as well as baseline MMSE (R2= 0.92, p < 0.005). These correlations depend on only two out of ten studies and should interpret cautiously.
authors.affiliation: Department of Anaesthesiology, Intensive Care and Pain Medicine, Saarland University Medical Center, Homburg, Germany.
authors.forename: Alexander
authors.initials: A
authors.lastname: Wolf
authors.affiliation: Department of Psychiatry and Psychotherapy, Klinikum rechts der Isar der Technischen Universität München, Ismaninger Str. 22, 81675, Munich, Germany.
authors.forename: Stefan
authors.initials: S
authors.lastname: Leucht
authors.affiliation: Department of Psychiatry and Psychotherapy, Klinikum rechts der Isar der Technischen Universität München, Ismaninger Str. 22, 81675, Munich, Germany. pajonk@psyspi.de.
authors.forename: Frank-Gerald
authors.identifier: http://orcid.org/0000-0001-8875-586X
authors.initials: FG
authors.lastname: Pajonk
mesh_terms: D014150:Antipsychotic Agents / Q000009:adverse effects*; D003072:Cognition Disorders / Q000139:chemically induced*; D016208:Databases, Factual / Q000706:statistics & numerical data; D003704:Dementia / Q000188:drug therapy*; D006801:Humans; D016032:Randomized Controlled Trials as Topic
chemical_list: D014150:Antipsychotic Agents
keywords: Antipsychotics; Cognition; Dementia; Meta-analysis