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Antipsychotic treatment effects on cardiovascular, cancer, infection, and intentional self-harm as cause of death in patients with Alzheimer's dementia

Published online by Cambridge University Press:  23 March 2020

R.-E. Nielsen ,
A. Lolk ,
M. Rodrigo-Domingo ,
J.-B. Valentin  and
K. Andersen
R.-E. Nielsen*
Affiliation:
Unit for Psychiatric Research, Aalborg University Hospital, Psychiatry, Mølleparkvej 10, 9000Aalborg, Denmark Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
A. Lolk
Affiliation:
Institute of Clinical Health, University of Southern Denmark, Department of Psychiatry, Odense, Region of Southern Denmark, Denmark
M. Rodrigo-Domingo
Affiliation:
Unit for Psychiatric Research, Aalborg University Hospital, Psychiatry, Mølleparkvej 10, 9000Aalborg, Denmark
J.-B. Valentin
Affiliation:
Unit for Psychiatric Research, Aalborg University Hospital, Psychiatry, Mølleparkvej 10, 9000Aalborg, Denmark
K. Andersen
Affiliation:
Institute of Clinical Health, University of Southern Denmark, Department of Psychiatry, Odense, Region of Southern Denmark, Denmark
*
*Corresponding author. Unit for Psychiatric Research, Aalborg University Hospital, Psychiatry, Mølleparkvej 10, 9000 Aalborg, Denmark. E-mail address:[email protected] (R.-E. Nielsen).
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Abstract

Background

Alzheimer's disease (AD), the most common disease causing dementia, is linked to increased mortality. However, the effect of antipsychotic use on specific causes of mortality has not yet been investigated thoroughly.

Methods

Utilizing the Danish nationwide registers, we defined a cohort of patients diagnosed with AD. Utilizing separate Cox regressions for specific causes of mortality, we investigated the effects of cumulative antipsychotic dosage after diagnosis and current antipsychotic exposure in the time period 2000–2011.

Results

In total, 45,894 patients were followed for 3,803,996 person-years. A total of 6129 cardiovascular related deaths, 2088 cancer related deaths, 1620 infection related deaths, and 28 intentional self-harm related deaths are presented. Current antipsychotic exposure increased mortality rate with HR between 1.92 and 2.31 for cardiovascular, cancer, and infection related death. Cumulative antipsychotic dosages were most commonly associated with increased rates of mortality for cardiovascular and infection as cause of death, whereas the associations were less clear with cancer and intentional self-harm as cause of death.

Conclusions

We showed that cumulative antipsychotic drug dosages increased mortality rates for cardiovascular and infection as cause of death. These findings highlight the need for further investigations of long-term effects of treatment and of possible sub-groups who could benefit from treatment.

Keywords

DementiaPsychopharmacologyMortalityEpidemiology
Type
Original article
Information
European Psychiatry , Volume 42 , May 2017 , pp. 14 - 23
Copyright
Copyright © European Psychiatric Association 2017

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