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60/100

✓ Peer-reviewed alzhub usefulness score 60 out of 100. Treatments

Reviewed as evidence on: Sedative/antipsychotic/mind-altering prescribing and falls, confusion, hospitalisation in dementia 4 studies (what the news said). Being listed means the study bears on the question, not that it agrees with the news.

Topic: Risk, prevention and care in population studies

Results Among 139 103 participants (105 372 [75.8%] female; mean [SD] age, 87.6 [7.7] years), 26 872 matched pairs were included in the benzodiazepine cohort and 10 240 in the antipsychotic cohort. Initiation of benzodiazepine use was associated with higher 180-day mortality compared with nonuse (HR, 1.41; 95% CI, 1.38-1.44), as was initiation of antipsychotic use (HR, 1.16; 95% CI, 1.12-1.20). These findings were consistent across propensity score-weighted models and with greater cumulative exposure. Conclusions and relevance 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. While these medications may provide symptom relief in appropriate clinical scenarios, their use is associated with substantial risks. These findings highlight the need for careful prescribing decisions and the development of dementia-specific hospice prescribing guidelines.

Cite this study APA, Vancouver, BibTeX · download .bib or .ris

APA 7th

Gerlach, L. B., Zhang, L., Kim, H. M., Teno, J., & Maust, D. T. (2025). Benzodiazepine or Antipsychotic Use and Mortality Risk Among Patients With Dementia in Hospice Care. JAMA Network Open. https://doi.org/10.1001/jamanetworkopen.2025.37551

Vancouver

Gerlach LB, Zhang L, Kim HM, Teno J, Maust DT. Benzodiazepine or Antipsychotic Use and Mortality Risk Among Patients With Dementia in Hospice Care. JAMA Network Open. 2025. doi:10.1001/jamanetworkopen.2025.37551. PMID: 41085983.

BibTeX

@article{gerlach2025-41085983,
  author  = {Gerlach, L. B. and Zhang, L. and Kim, H. M. and Teno, J. and Maust, D. T.},
  title   = {{Benzodiazepine or Antipsychotic Use and Mortality Risk Among Patients With Dementia in Hospice Care}},
  journal = {JAMA Network Open},
  year    = {2025},
  doi     = {10.1001/jamanetworkopen.2025.37551},
  pmid    = {41085983},
  url     = {https://doi.org/10.1001/jamanetworkopen.2025.37551}
}

Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. Check the citation against the original before you use it.

Key findings

Results Among 139 103 participants (105 372 [75.8%] female; mean [SD] age, 87.6 [7.7] years), 26 872 matched pairs were included in the benzodiazepine cohort and 10 240 in the antipsychotic cohort.
Initiation of benzodiazepine use was associated with higher 180-day mortality compared with nonuse (HR, 1.41; 95% CI, 1.38-1.44), as was initiation of antipsychotic use (HR, 1.16; 95% CI, 1.12-1.20).
These findings were consistent across propensity score-weighted models and with greater cumulative exposure.
Conclusions and relevance 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.
While these medications may provide symptom relief in appropriate clinical scenarios, their use is associated with substantial risks.

Why it matters

In this study of nursing home residents with dementia receiving hospice care, starting benzodiazepines or antipsychotics was associated with higher 180-day mortality. The authors call for careful prescribing decisions and dementia-specific hospice prescribing guidelines.

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Study details

Study designcase-control
Participants139,103
Effect size180-day mortality HR 1.41 (95% CI 1.38-1.44) for benzodiazepines; HR 1.16 (95% CI 1.12-1.20) for antipsychotics
Evidence strengthModerate

Limitations

Observational; drugs may be started because the person is deteriorating (confounding by indication); mortality is expected in hospice so the outcome is about timing, not whether death occurs; nursing home residents only.

How this study scored 60/100

Published in a leading specialty journal, and it is a case-control study. Scored zero for randomized / blinded because the record does not state it. We have no data on free to read, so that was left out: it earned 59 of the 98 points we could judge it on, which is 60 out of 100.

Component	Points	Why
Journal tier	9 / 10	Tier 2 — leading specialty journal (JAMA Network Open)
Journal's citation record	2 / 4	JAMA Network Open: journal h-index 235 (OpenAlex, 2026-10-29)
Study design	6 / 12	A case-control study
Strength of evidence	3 / 5	Rated “moderate” in our summary
Peer-review validation	10 / 10	Peer-reviewed. Published as an article in a named peer-reviewed journal.
How recent	4 / 5	2025 — within 3 year(s) of the newest study here
Sample size	4 / 4	139,103 participants
Effect reported	3 / 3	Effect reported with a statistic (interval, p-value, ratio or similar)
Studied in people	3 / 3	Studied in people (participant count stated)
Randomized / blinded	0 / 2	No randomization or blinding stated — scores zero (not stated in the record — scored 0)
Times cited	2 / 7	Cited 7 times (OpenAlex, 2026-10-10)
Citations per year	1 / 5	2.3 citations a year over 3 year(s) since 2025
Impact for its field and year	3 / 6	Cited 3.7× the average for papers of its field and year (OpenAlex FWCI)
Cited by studies here	0 / 6	No other study in this library cites it
Still being cited	1 / 4	Cited 7 times in 2024–2026 (2026 still in progress; OpenAlex)
Senior author's track record	2 / 4	Last-listed author Donovan T. Maust: h-index 35 (OpenAlex, whole career)
Institution's track record	2 / 3	University of Michigan: institution h-index 2,240 (OpenAlex)
Multicenter collaboration	2 / 3	OpenAlex lists 5 institution(s) in 1 country
Indexed in PubMed	2 / 2	Indexed in PubMed (PMID 41085983)
Free to read	— / 2	Access not recorded — left out of this score
Points	59 / 98	Scored on 19 of 20 parts. We have no data for the rest, so they are left out: 59 of the 98 points we could judge it on is 60 out of 100.
Total	60 / 100	—

What each of these 20 components measures, and what this score is not →

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