A surreal illustration representing the challenges of dementia care.

Unmasking Antipsychotic Use in Dementia: A Comprehensive Guide for Caregivers and Families

Lena Kashyap in Health & Wellness July 2025 • 4 min read.

"Navigating the complexities of dementia care: Understanding antipsychotic usage, associated factors, and informed decision-making for loved ones."

Dementia presents immense challenges, not only for those diagnosed but also for their families and caregivers. Managing the behavioral and psychological symptoms of dementia (BPSD) is often a primary concern, leading to the use of antipsychotic medications. These drugs, while sometimes effective in alleviating distressing symptoms, come with significant risks, including increased mortality and cerebrovascular events. This creates a difficult balancing act for healthcare professionals and families seeking the best possible care.

Previous research in Japan has attempted to quantify the use of antipsychotics among older adults with dementia, often focusing on individuals already taking antidementia drugs. However, these studies may not fully capture the broader picture, as many people with dementia do not receive these specific medications. This article aims to provide a more comprehensive understanding of antipsychotic use in this population, drawing on a robust study that incorporates both medical and long-term care data.

By exploring the factors associated with antipsychotic use and examining the prevalence across different subgroups of individuals with dementia, this guide seeks to empower caregivers and families with the knowledge they need to make informed decisions about treatment options and advocate for the well-being of their loved ones. This includes understanding potential risks, considering alternative strategies, and actively participating in care planning.

What Factors Influence Antipsychotic Use in Dementia?

A surreal illustration representing the challenges of dementia care.

A recent study published in the Geriatrics & Gerontology International journal investigated the prevalence of antipsychotic use among individuals aged 75 and older with dementia in Japan. Unlike previous research, this study incorporated both medical and long-term care (LTC) data to create a more comprehensive view. The researchers analyzed data from a middle-sized suburban city, examining medical claims, LTC claims, and LTC certification records from April 2012 to September 2013. This approach allowed them to identify individuals with dementia regardless of whether they were taking antidementia medications.

The study revealed several key factors associated with antipsychotic use among people with dementia:

Cognitive Impairment: Individuals with lower cognitive function were more likely to be prescribed antipsychotics.
Antidementia Drug Use: Those already taking antidementia drugs also had a higher likelihood of antipsychotic use.
Institutional LTC Services: The use of institutional long-term care services was associated with increased antipsychotic prescriptions.
Age: Interestingly, older age (92 years and older) was linked to lower odds of antipsychotic use.

These findings suggest that antipsychotic use is influenced by a complex interplay of factors related to the severity of dementia, the types of care received, and the individual's overall health status. The study highlights the need for a nuanced approach to prescribing these medications, considering the specific needs and circumstances of each person with dementia.

Moving Forward: Informed Decisions and Compassionate Care

Understanding the factors that contribute to antipsychotic use in dementia is crucial for families and caregivers. By being informed about the potential risks and benefits of these medications, exploring alternative management strategies for BPSD, and actively participating in care planning, you can advocate for the best possible quality of life for your loved one. Remember, compassionate care prioritizes individual needs and seeks to minimize the use of potentially harmful medications whenever possible. Open communication with healthcare providers is essential to navigate the complexities of dementia care and ensure that treatment decisions align with the values and preferences of the individual and their family.

About this Article -

This article was crafted using a human-AI hybrid and collaborative approach. AI assisted our team with initial drafting, research insights, identifying key questions, and image generation. Our human editors guided topic selection, defined the angle, structured the content, ensured factual accuracy and relevance, refined the tone, and conducted thorough editing to deliver helpful, high-quality information.See our About page for more information.

This article is based on research published under:

DOI-LINK: 10.1002/gps.5041, Alternate LINK

Title: Antipsychotic Use And Related Factors Among People With Dementia Aged 75 Years Or Older In J Apan: A Comprehensive Population‐Based Estimation Using Medical And Long‐Term Care Data

Subject: Psychiatry and Mental health

Journal: International Journal of Geriatric Psychiatry

Publisher: Wiley

Authors: Naoaki Kuroda, Shota Hamada, Nobuo Sakata, Boyoung Jeon, Katsuya Iijima, Satoru Yoshie, Tatsuro Ishizaki, Xueying Jin, Taeko Watanabe, Nanako Tamiya

Published: 2018-12-27

Everything You Need To Know

What are the primary challenges in dementia care that often lead to the use of antipsychotic medications?

The primary challenges in dementia care revolve around managing the Behavioral and Psychological Symptoms of Dementia (BPSD). These symptoms can be distressing for both the individual with dementia and their caregivers, prompting the use of antipsychotic medications. While antipsychotics may offer some relief from these symptoms, it's crucial to acknowledge the associated risks, such as increased mortality and cerebrovascular events. Therefore, balancing the potential benefits against these risks is a central dilemma in dementia care.

How does the prevalence of antipsychotic use in dementia differ based on the type of care setting and what does a recent study suggest about it?

A recent study, unlike previous research, incorporated both medical and long-term care (LTC) data to create a comprehensive view of antipsychotic use in dementia. The study found that the use of institutional Long-Term Care (LTC) services was associated with increased antipsychotic prescriptions. This suggests that individuals in institutional settings might be more likely to receive antipsychotics, potentially due to factors like staffing ratios or the severity of symptoms. This highlights the importance of considering the care environment when evaluating treatment options.

What specific factors identified in the study conducted in Japan influence the likelihood of antipsychotic use in older adults with dementia?

The study identified several key factors. Individuals with lower Cognitive Impairment were more likely to be prescribed antipsychotics. Those already taking Antidementia drugs also had a higher likelihood of antipsychotic use. Furthermore, the use of institutional Long-Term Care (LTC) services was linked to increased antipsychotic prescriptions. Interestingly, older age (92 years and older) was associated with lower odds of antipsychotic use, suggesting a complex interplay of factors influencing these prescribing decisions.

Why is it important for families and caregivers to be informed about antipsychotic use in dementia, and what steps should they take?

Being informed is crucial because antipsychotic medications carry significant risks, including increased mortality and cerebrovascular events. Families and caregivers should understand the potential benefits and risks of these medications, explore alternative management strategies for BPSD, and actively participate in care planning. Open communication with healthcare providers is essential to make informed decisions that align with the individual's values and preferences, prioritizing the best possible quality of life and minimizing the use of potentially harmful medications.

Beyond medication, what other strategies can be considered for managing the Behavioral and Psychological Symptoms of Dementia (BPSD)?

While the provided text primarily discusses antipsychotic use, it emphasizes the importance of exploring alternative management strategies for BPSD. Although the article doesn't explicitly detail these alternatives, the context encourages considering non-pharmacological interventions. These could include behavioral therapies, environmental modifications, and caregiver training, all aimed at reducing BPSD symptoms and potentially minimizing the need for antipsychotic medications. The specific alternatives would depend on the individual's needs and the nature of their symptoms.