Antipsychotics are associated with a higher risk of death in older adults with dementia, no matter the existence of cardiovascular comorbidities or diabetes, a new study has found.

The matched cohort study used a Danish national database to examine mortality risk among patients aged 65 to 95 years old who were diagnosed with dementia. Investigators compared rates of death within 180 days after antipsychotic treatment was initiated. Results were analyzed to determine whether diabetes, heart disease and cerebrovascular disease interacted with antipsychotic treatment to increase patients’ mortality risk.

Patients who were prescribed antipsychotics had a significantly higher odds of dying within the study period than those who did not take the drugs. Mortality rates were higher among those with heart disease and diabetes when compared with patients without comorbidities. But an analysis found no relative excess risk due to interaction between heart disease, cerebrovascular disease or diabetes and the antipsychotic drugs, reported Ane Norgaard M.D., Ph.D., of the University of Copenhagen in Denmark.

The study echoes years of evidence underscoring the downsides of prescribing antipsychotics in seniors with dementia. People with Alzheimer’s disease, for example, face a higher risk of stroke shortly after starting a course of the drugs. And a large 2020 study in Finland found that antipsychotics use increases head and traumatic brain injury risk due to falls in people with Alzheimer’s disease, McKnight’s has reported

The current study “adds to the evidence that antipsychotic treatment is associated with increased mortality and suggests that attention should be paid to all initiators of antipsychotics irrespective of cardiovascular disease and diabetes,” the authors concluded.

Full findings were published in the Journal of the American Geriatrics Society.