Older adults with dementia who take antipsychotics are more likely to be hospitalized or die, even if they take the drugs for a very short time, according to a retrospective study. Researchers compared 20,682 older adults with dementia living in the community with 20,559 similar patients living in a nursing home. The subjects were divided into three groups: those who didn't take antipsychotics, those who took an atypical antipsychotic drug such as olanzapine (Zyprexa), and those who took a conventional antipsychotic drug such as haloperidol (Haldol).

Community-dwelling older adults who'd recently received a prescription for an atypical antipsychotic drug were 3.2 times more likely to be hospitalized or die during 30 days of follow-up than community-dwelling adults who'd received no antipsychotic drug therapy. Likewise, older adults who'd received a conventional antipsychotic drug were 3.8 times more likely to develop a serious event than those who hadn't taken any antipsychotic drug.

Among nursing home patients, those who took an atypical drug were 2.4 times more likely to be hospitalized or die during 30 days of follow-up, and those taking a conventional drug were 1.9 times more likely to be hospitalized or die.

Antipsychotic drugs are typically administered to older adults with dementia to manage aggression and agitation, despite evidence that these drugs are risky for older adults with dementia. The researchers recommend using antipsychotic drugs "with caution" in older adults with dementia, even for short-term therapy.

Source: Rochon PA, et al., Antipsychotic therapy and short-term serious events in older adults with dementia, Archives of Internal Medicine, May 26, 2008.