Seventeen studies (5373 patients) were included. 5 key findings →
Design: meta-analysis Participants: 5,373 Evidence: high
Full summary, score breakdown and related studies → Original source
Research
27,380 Alzheimer's and dementia studies in plain English, each scored out of 100.
Atypical antipsychotic drugs may be associated with a small increased risk for death compared with placebo. 2 key findings →
Design: meta-analysis Participants: 3,353 Evidence: high
Full summary, score breakdown and related studies → Original source Full text may need a subscription
Costs were calculated using cost function figures compared with usual costs. 5 key findings →
Design: randomized controlled trial Participants: 847 Evidence: high
Full summary, score breakdown and related studies → Original source
Among 14 placebo-controlled trials of elderly patients with dementia reporting a total global outcome score that includes symptoms such as psychosis, mood alterations, and aggression, small but statistically significant effects sizes ranging from 0.12 and 0.20 were observed for aripiprazole, olanzapine, and risperidone. 5 key findings →
Design: systematic review Participants: 1,000 Evidence: high
Full summary, score breakdown and related studies → Original source
We aimed to assess whether continued treatment with antipsychotics in people with AD is associated with an increased risk of mortality. 5 key findings →
Participants: 165 Evidence: high
Full summary, score breakdown and related studies → Original source
Promotion of person centred care and good practice in the management of patients with dementia with behavioural symptoms provides an effective alternative to neuroleptics. 2 key findings →
Design: randomized controlled trial Evidence: high
Full summary, score breakdown and related studies → Original source
Antipsychotic use compared with non-use in adults with dementia was associated with increased risks of stroke, venous thromboembolism, myocardial infarction, heart failure, fracture, pneumonia, and acute kidney injury, but not ventricular arrhythmia. 5 key findings →
Design: cohort Participants: 173,910 Evidence: moderate
Full summary, score breakdown and related studies → Original source Free full text
Quality of the reporting of trials varied. 3 key findings →
Design: meta-analysis Participants: 3,353 Evidence: high
Full summary, score breakdown and related studies → Original source
The study cohort consisted of 178,441 older adults with dementia who were new users of ChEIs. 5 key findings →
Design: cohort study Participants: 23,433 Evidence: moderate
Full summary, score breakdown and related studies → Original source
However, the advisory did not apply to conventional antipsychotic medications; the risk of death with these older agents is not known. 1 key finding →
Design: cohort study Participants: 22,890 Evidence: moderate
Full summary, score breakdown and related studies → Original source Free full text
Atypical antipsychotic use is associated with an increased risk for death compared with nonuse among older adults with dementia. 5 key findings →
Design: cohort study Participants: 27,259 Evidence: moderate
Full summary, score breakdown and related studies → Original source Full text may need a subscription
Analysis included patients treated with an atypical antipsychotic, compared with placebo Main results Sixteen placebo controlled trials have been completed with atypical antipsychotics although only nine had sufficient data to contribute to a meta-analysis and only five have been published in full in peer reviewed journals. 5 key findings →
Design: systematic review Evidence: high
Full summary, score breakdown and related studies → Original source
Compared with respective matched nonusers, individuals receiving haloperidol had an increased mortality risk of 3.8% (95% CI, 1.0%-6.6%; P Conclusions and relevance The absolute effect of antipsychotics on mortality in elderly patients with dementia may be higher than previously reported and increases with dose. 5 key findings →
Design: case-control study Participants: 90,786 Evidence: moderate
Full summary, score breakdown and related studies → Original source Free full text
Antipsychotic initiation and use were common during hospitalization, most often for delirium, and individuals were frequently discharged on these medications. 3 key findings →
Design: cohort study Participants: 17,775 Evidence: moderate
Full summary, score breakdown and related studies → Original source
The use of APs by patients with dementia in the general population is associated with increased mortality, but whether this risk extends to patients with PD remains unknown. 5 key findings →
Design: cohort study Participants: 7,877 Evidence: moderate
Full summary, score breakdown and related studies → Original source
Adverse effects offset advantages in the efficacy of atypical antipsychotic drugs for the treatment of psychosis, aggression, or agitation in patients with Alzheimer's disease. 4 key findings →
Evidence: low
Full summary, score breakdown and related studies → Original source
67/100
Decrease in delirium scores were not significantly different comparing the effect of low dose haloperidol (< 3.0 mg per day) with the atypical antipsychotics olanzapine and risperidone (Odds ratio 0.63 (95% CI 10.29 - 1.38; p = 0.25). 5 key findings →
Evidence: high
Full summary, score breakdown and related studies → Original source
In covariate-adjusted intent-to-treat analyses, haloperidol was associated with the highest mortality rates (relative risk=1.54, 95% confidence interval [CI]=1.38-1.73) followed by risperidone (reference), olanzapine (relative risk=0.99, 95% CI=0.89-1.10), valproic acid and its derivatives (relative risk=0.91, 95% CI=0.78-1.06), and quetiapine (relative risk=0.73, 95% CI=0.67-0.80). 5 key findings →
Design: cohort study Participants: 33,604 Evidence: moderate
Full summary, score breakdown and related studies → Original source
In elderly persons, antipsychotic drugs are clinically prescribed off-label for a number of disorders outside of their Food and Drug Administration (FDA)-approved indications (schizophrenia and bipolar disorder). 3 key findings →
Design: meta-analysis Evidence: high
Full summary, score breakdown and related studies → Original source Free full text
There were no differences in measures of effectiveness between initiation of active treatments or placebo (which represented watchful waiting) but the placebo group had significantly lower health care costs. 3 key findings →
Design: clinical trial Participants: 421 Evidence: high
Full summary, score breakdown and related studies → Original source Full text may need a subscription
60/100
In this national case-control study of nursing home residents with ADRD receiving hospice care, initiation of benzodiazepine or antipsychotic use was associated with increased 180-day mortality. 5 key findings →
Design: case-control Participants: 139,103 Evidence: moderate
Full summary, score breakdown and related studies → Original source Free full text
This study indicates no benefits for memantine in the long-term treatment and prophylaxis of clinically significant neuropsychiatric symptoms. 5 key findings →
Participants: 199 Evidence: high
Full summary, score breakdown and related studies → Original source Free full text
In AD patients with symptoms of psychosis, agitation, or aggressive behavior, medications can have a small but significant impact on caregiver burden. 4 key findings →
Design: clinical trial Participants: 361 Evidence: high
Full summary, score breakdown and related studies → Original source Free full text
APs appear to increase the risk of hip fracture among older adults with dementia residing in an NH. 3 key findings →
Design: case-control study Participants: 586 Evidence: moderate
Full summary, score breakdown and related studies → Original source
Though these findings cannot prove causality, and we cannot rule out the possibility of residual confounding, they provide more evidence of the risk of using these drugs in older patients, reinforcing the concept that they should not be used in the absence of clear need. 4 key findings →
Design: cohort study Evidence: moderate
Full summary, score breakdown and related studies → Original source
Where “Free full text” comes from
Free full text links and the Full text may need a subscription label come from Unpaywall, Europe PMC and OpenAlex records of free copies, checked 10 Oct 2026. A study with neither is unknown, not paywalled. Show only studies that are free to read
How the 0–100 score works — and why some entries are capped
This is alzhub's own score. It is not an official metric, not an impact factor, and no journal, publisher or ranking body endorses it. We built it so that a reader who is not a scientist can tell a landmark trial from a conference abstract without having to already know the difference. Every point comes from one of 20 components, all of them printed on the study itself, so you can disagree with our arithmetic rather than having to trust the total.
- Journal tier up to 10 pts
- Journal's citation record up to 4 pts
- Study design up to 12 pts
- Strength of evidence up to 5 pts
- Peer-review validation up to 10 pts
- How recent up to 5 pts
- Sample size up to 4 pts
- Effect reported up to 3 pts
- Studied in people up to 3 pts
- Randomised / blinded up to 2 pts
- Times cited up to 7 pts
- Citations per year up to 5 pts
- Impact for its field and year up to 6 pts
- Cited by studies here up to 6 pts
- Still being cited up to 4 pts
- Senior author's track record up to 4 pts
- Institution's track record up to 3 pts
- Multi-centre collaboration up to 3 pts
- Indexed in PubMed up to 2 pts
- Free to read up to 2 pts
Journals are placed in ordered tiers, never given a numeric impact factor — we could not verify current impact factors from a source we control, and an invented one would be worse than none. Tier 1 is the top-tier general journals (NEJM, The Lancet, JAMA, Nature, Science, Nature Medicine); tier 2 is the leading specialty journals; tier 3 is every other peer-reviewed journal. A separate part scores how much the journal's own papers are cited, which tells the tier-3 journals apart.
Two rules we don't bend. First, we never fill in a missing value: if a record does not state a sample size or a design, that component scores zero, and if we simply have no data for a part, such as a citation count, that part is left out and the study is scored on the parts we could check. The study card says which. Second, anything that is not a peer-reviewed article is capped at 16/100 and carries a warning chip — so a conference abstract or a company press release can never outrank a peer-reviewed paper, no matter how good it looks.
We rank a rigorous null result — a good trial showing that something does not work — above an early positive finding. Someone deciding whether to buy a supplement is served by that, and the rigour is already counted by the design and journal components.
The score is computed from the published data alone and is reproducible: the same file always yields the same numbers.
See the whole rubric drawn out → — four charts covering all 27,380 studies: how the scores are spread and where the cap bites, which of the 20 components the library is strong and weak on, which subjects rest on stronger evidence, and what kinds of study each subject is actually built from.
What this library is — and isn't
This is a large sample of the Alzheimer's literature, not an exhaustive index of it. It holds 27,380 records, built mostly from automated pulls of Europe PMC (60.6% of the library) and OpenAlex (18.6%), plus smaller pulls from PubMed, Crossref and medRxiv. If a study, a drug, or a finding isn't here, that is not evidence it doesn't exist in the literature — it may simply not have been pulled in yet.
1,032 records (3.8% of the library) are not peer-reviewed — 962 of those are preprints posted before any journal review, and the rest are conference abstracts, regulatory notices and reports. Every study card on this page states its status plainly, and the score above is capped for anything that isn't a peer-reviewed article.
See the full, machine-readable breakdown of this library's coverage →