J Korean Geriatr Psychiatry.  2021 Oct;25(2):70-75. 10.47825/jkgp.2021.25.2.70.

Association of Antipsychotics and Behavioral and Psychological Symptoms of Dementia With Cognitive Decline in Subjects With Alzheimer’s Disease

• Chang JH
• Jon D
• Hong HJ
• Jung MH
• Hong N

• KMID: 2522238
• DOI: http://doi.org/10.47825/jkgp.2021.25.2.70

Abstract

Objective
Neuropsychiatric symptoms are common among patients with major neurocognitive disorder. Antipsychotic medica-tions have been widely used to manage behavioral and psychological symptoms of dementia (BPSD), however efficacy and safety of these agents are conflicting. In this study, we tried to overview the association of antipsychotic medication use and neuropsychi-atric symptoms with cognitive decline in patients with Alzheimer’s disease.
Methods
We reviewed the medical charts of patients who were diagnosed as major neurocognitive disorder due to Alzheimer’s disease from November 2014 to October 2015. We reviewed whether the subjects had used antipsychotics, and whether patients had neuropsychiatric symptoms. We used linear mixed models to examine the statistical difference between each group.
Results
Total of 106 subjects were included in the study. There was no statistically significant difference in cognitive function decline (Korean Version of Mini-Mental State Examination score change) between subjects with or without BPSD (p=0.62), and between subjects with or without antipsychotic medication (p=0.09).
Conclusion
There was no evidence that antipsychotic medication and BPSD are associated with more cognitive decline. Findings imply that neuropsychiatric symptoms and cognitive impairment come from different etiologic causes, which highlights the heterogeneity of the disorder. Clinician should decide whether to use antipsychotic medication while carefully considering the effect and side effects of antipsychotic medication throughout the treatment period.

Keyword

Alzheimer disease; Antipsychotic agent; Behavioral and psychological symptoms of dementia; Cognitive function; Dementia