Association of Typical and Atypical Antipsychotics with Mortality in Older Adults with Schizophrenia: a 5-year multicenter prospective study.

Abstract

Objective: Uncertainty exists over whether atypical and typical antipsychotics differ in the strength of their association with mortality among older people with schizophrenia. Here, we examined whether mortality rates and its causes significantly differ between older adults with schizophrenia taking atypical or typical antipsychotics.

Methods: In a 5-year prospective multicenter study of patients aged ≥55 years with an ICD-10 diagnosis of schizophrenia, we used a multivariable logistic regression model to examine the association of atypical versus typical antipsychotics with mortality, adjusting for sociodemographic and clinical characteristics.

Results: Of 313 older adults with schizophrenia, the 5-year all-cause mortality rates in patients taking atypical (N=192) and typical (N=167) antipsychotics were 36.4% and 24.3%, respectively. Following adjustment, there were not significant differences in all-cause mortality (AOR=1.56; 95%CI=0.75-3.27; p=0.24) or in death causes (all p-values>0.05) between patients taking atypical or typical antipsychotics. Atypical versus typical antipsychotics were significantly associated with decreased overall mortality in the subpopulation of participants with a baseline MMSE score<24 (AOR=0.24; 95%CI=0.07-0.84; p=0.025).

Conclusions: Use of atypical antipsychotics compared to typical antipsychotics may not associated with different odds of overall mortality in older people with schizophrenia, but might be associated with reduced mortality among those with substantial cognitive impairment.