Predictors of antipsychotic usage among patients with dementias and mild cognitive impairment

Abstract

AbstractBackgroundAntipsychotics are commonly used to control a variety of psychotic symptoms e.g. agitation, or aggression and wandering behaviors which are part of behavioral and psychological symptoms of dementia (BPSD) in various dementias and mild cognitive impairment (MCI). Despite their extensive usage in these patients, predictors of their usage are unknown.MethodA total of 948 patients with memory/cognitive complaints from July 2012 to December 2015 were screened in the present study. Those who met the diagnosis of MCI [Clinical Dementia Rating (score=0.5)] or Diagnostic and Statistical Manual‐IV (DSM‐IV) for diagnosis of dementia were recruited for the present study if they had BPSD and were on antipsychotic drugs. Fazekas White Matter Lesion (WMLs) Score was used to study the WMLs leasion load. BEHAVE‐AD scale was used to rate the severity of cases.ResultWe found a total of 398 patients with dementias and [M:F=330:68] and 550 patients with MCI with the mean age 74±4.1 and duration of illnesses 3.1±1.2 years were studied. In the MCI group [348: 198], the mean age was 64±3.1 and duration of illnesses 2.1±1.2 years. Antipsychotics were most likely used by those with vascular dementia, mixed dementias, AD with white matter lesions, dementia with co morbidities; and those with advanced illness. Patients older than 85 years were more likely to be on antipsychotics. Adverse effects of antipsychotics in elderly with dementias were common.ConclusionCertain categories of patients in dementia/MCI groups are more likely to receive antipsychotics than other patients.