In older adults with dementia, antipsychotics are associated with an increased risk of:

• A. Stroke and cognitive decline.
• B. Improved mortality.
• C. No impact on cognitive function.
• D. Preferred treatment for behavioral symptoms.

Answer: (A)

Antipsychotics in older adults with dementia carry significant safety concerns, particularly an increased risk of cerebrovascular events and cognitive decline. Regulatory warnings and multiple studies show that these drugs are associated with higher rates of stroke and with worsening cognitive function in this population. Because of these harms, they are not a preferred treatment for behavioral symptoms and mortality can be increased as well. Nonpharmacologic approaches should be tried first, and if medication is necessary, it should be used at the lowest effective dose with close monitoring.