Clinical Manifestations.

Abstract

during the dementia time course Behavioral and Psychological Symptoms of Dementia (BPSD) may arise. Despite their use is still off-label and they are associated with several side effects, antipsychotics represent the main pharmacological strategy to alleviate BPDS METHOD: aim of this retrospective study was to evaluate the correlation between antipsychotics use and all-cause mortality. BPSD were classified in three clusters: "mood/apathy", "psychosis" and "hyperactivity". ANOVA for repeated measures was used to evaluate the functional/cognitive changes over three time points (baseline, 6 months and 12 months follow-up). Chi-Square test was carried out to verify the correlation between antipsychotic drug use and mortality. Logistic regression and stepwise regression method were used to analyze the relationship between mortality and other potential influencing factors, including ADL, IADL, CFS, in addiction of antipsychotics drugs use. a total of 209 patients with a clinical diagnosis of dementia were enrolled (71.3% women; mean age = 83.24±4.98 years). The results of the ANOVA indicated a significant worsening of ADL and IADL over time [ADL Wilks' Lambda = 0.744, F(2,80) = 13.75, p<0.001, η2 = 0.256, IADL Wilks' Lambda = 0.71, F(2,80) = 16.3, p<0.001, η2 = 0.29, respectively], a significant progression of cognitive impairment as measured with MMSE and a significant worsening in frailty at CFS at 6 and 12 months follow up [MMSE Wilks' Lambda = 0.751, F(2,73) = 12.11, p<0.001, η2 = 0.249, CFS Wilks' Lambda = 0.749, F(2,79) = 13.224, p<0.001, η2 = 0.241]. Patients on antipsychotic therapy reported a higher mortality rate, although there is no statistically significant association between antipsychotic use and mortality. We found no significant correlation between mortality and antipsychotic drug use within the different BPSD cluster ("mood/apathy" p = 0.464, "psychosis" p = 0.569, "hyperactivity" 0.528), and no statistically significant association between mortality and other potential influencing factors. Using a stepwise regression, the loss of independence in IADL survived as factor associated to mortality (p = 0.002). patients on antipsychotic therapy reported a higher mortality rate, although there is no statistically significant association between antipsychotic use and mortality. Further work is needed to establish the relationship between antipsychotics and mortality in elderly patients with dementia.