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54/100

✓ Peer-reviewed alzhub usefulness score 54 out of 100. Disparities

Topic: Risk, prevention and care in population studies

Context Use of atypical antipsychotics for neuropsychiatric symptoms of dementia increased markedly in the 1990s. Concerns about their use began to emerge in 2002, and in 2005, the US Food and Drug Administration warned that use of atypical antipsychotics in dementia was associated with increased mortality. Objective To examine changes in atypical and conventional antipsychotic use in outpatients with dementia from 1999 through 2007. Design Time-series analyses estimated the effect of the various warnings on atypical and conventional antipsychotic usage using national Veterans Affairs data across 3 periods: no warning (1999-2003), early warning (2003-2005), and black box warning (2005-2007). Subjects Patients aged 65 years or older with dementia (n = 254 564). Main outcome measures Outpatient antipsychotic use (percentage of patients, percentage of quarterly change, and difference between consecutive study periods). Results In 1999, 17.7% (95% confidence interval [CI], 17.2-18.1) of patients with dementia were using atypical or conventional antipsychotics. Overall use began to decline during the no-warning period (rate per quarter, -0.12%; 95% CI, -0.16 to -0.07; P Conclusions Use of atypical antipsychotics began to decline significantly in 2003, and the Food and Drug Administration advisory was temporally associated with a significant acceleration in the decline.

Key findings

Concerns about their use began to emerge in 2002, and in 2005, the US Food and Drug Administration warned that use of atypical antipsychotics in dementia was associated with increased mortality.
Results In 1999, 17.7% (95% confidence interval [CI], 17.2-18.1) of patients with dementia were using atypical or conventional antipsychotics.
Overall use began to decline during the no-warning period (rate per quarter, -0.12%; 95% CI, -0.16 to -0.07; P < .001).

Why it matters

This study found that antipsychotic use in dementia declined after warnings about increased mortality risk. It does not test any treatment, cure, or prevention for Alzheimer's disease.

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Study details

Participants254
Effect size17.7%; 0.12%
Evidence strengthLow

How this study scored 54/100

Published in a peer-reviewed journal. Scored zero for study design and randomised / blinded because the record does not state it.

Component	Points	Why
Journal tier	7 / 10	Tier 3 — peer-reviewed journal (Archives of general psychiatry)
Journal's citation record	4 / 4	Archives of General Psychiatry: journal h-index 543 (OpenAlex, 2026-10-29)
Study design	0 / 12	No study design recorded — scores zero, not guessed (not stated in the record — scored 0)
Strength of evidence	1 / 5	Rated “low” in our summary
Peer-review validation	10 / 10	Peer-reviewed. Published as an article in a named peer-reviewed journal.
How recent	1 / 5	2011 — within 20 year(s) of the newest study here
Sample size	2 / 4	254 participants
Effect reported	2 / 3	Effect reported as a number, without an interval or test
Studied in people	3 / 3	Studied in people (participant count stated)
Randomised / blinded	0 / 2	No randomisation or blinding stated — scores zero (not stated in the record — scored 0)
Times cited	5 / 7	Cited 171 times (OpenAlex, 2026-10-10)
Citations per year	3 / 5	10.1 citations a year over 17 year(s) since 2011
Impact for its field and year	4 / 6	Cited 13.1× the average for papers of its field and year (OpenAlex FWCI)
Cited by studies here	2 / 6	Cited by 5 other studies in this library
Still being cited	1 / 4	Cited 6 times in 2024–2026 (2026 still in progress; OpenAlex)
Senior author's track record	3 / 4	Last-listed author Frederic C. Blow: h-index 83 (OpenAlex, whole career)
Institution's track record	2 / 3	University of Michigan: institution h-index 2,240 (OpenAlex)
Multi-centre collaboration	2 / 3	OpenAlex lists 4 institution(s) in 1 country
Indexed in PubMed	2 / 2	Indexed in PubMed (PMID 21300946)
Free to read	0 / 2	Behind a paywall — scores zero
Total	54 / 100	—

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

Read the original

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APA 7th

Kales, H. C., Zivin, K., Kim, H. M., Valenstein, M., Chiang, C., Ignacio, R. V., et al. (2011). Trends in antipsychotic use in dementia 1999-2007. Archives of general psychiatry. https://doi.org/10.1001/archgenpsychiatry.2010.200

Vancouver

Kales HC, Zivin K, Kim HM, Valenstein M, Chiang C, Ignacio RV, et al. Trends in antipsychotic use in dementia 1999-2007. Archives of general psychiatry. 2011. doi:10.1001/archgenpsychiatry.2010.200. PMID: 21300946.

BibTeX

@article{kales2011-21300946,
  author  = {Kales, H. C. and Zivin, K. and Kim, H. M. and Valenstein, M. and Chiang, C. and Ignacio, R. V. and Ganoczy, D. and Cunningham, F. and others},
  title   = {{Trends in antipsychotic use in dementia 1999-2007}},
  journal = {Archives of general psychiatry},
  year    = {2011},
  doi     = {10.1001/archgenpsychiatry.2010.200},
  pmid    = {21300946},
  url     = {https://doi.org/10.1001/archgenpsychiatry.2010.200}
}

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