INTRODUCTION Guidelines recommend short-term targeted use of antipsychotic medications for behavioral and psychological symptoms of dementia only when other strategies have failed. Antipsychotic prescribing in dementia is common internationally, but data on duration of use are limited. Our objectives were to determine duration, time to initiation, and prevalence of antipsychotic use among people with dementia. METHODS This work was a retrospective dynamic cohort study of people aged 65 years or above with dementia in 68 residential aged facilities during the period spanning from 2014 to 2017. Medication administration records were used to identify antipsychotic medication use. Medication outcomes (prevalence, duration, and time to initiation) were estimated using regression. Covariates included comorbidities and sociodemographic and facility characteristics. RESULTS A total of 5825 residents with dementia were identified. The annual prevalence of antipsychotic use ranged from 27.6% to 32.6%. Mean time to initiation after admission was 308.4 days (for female individuals) and 173.2 days (for male individuals). An overall 65% of people who used antipsychotics did so for >3 months even without psychiatric comorbidities; mean durations were 212.74 (95% confidence interval: 170.24, 255.25) days (for female individuals) and 216.10 (95% confidence interval: 165.31, 266.89) days (for male individuals) at median ages. DISCUSSION Antipsychotics are often used longer than recommended. Current guidelines and restrictions may be insufficient to limit antipsychotic medication use. Further efforts are needed to ensure that antipsychotic medications are used as recommended in dementia.

中文翻译：

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老年痴呆症患者使用抗精神病药物的持续时间。

简介指南建议仅在其他策略失败的情况下，针对性痴呆的行为和心理症状短期使用抗精神病药物。痴呆症中的抗精神病药处方在国际上很普遍，但是使用期限的数据有限。我们的目标是确定痴呆症患者的抗精神病药物治疗的持续时间，开始时间和流行程度。方法这项工作是一项回顾性动态队列研究，研究对象为2014年至2017年期间68个住宅老年设施中65岁或以上的痴呆症患者。药物治疗记录用于确定抗精神病药物的使用。使用回归评估药物治疗的结果（患病率，持续时间和开始时间）。协变量包括合并症，社会人口统计学和设施特征。结果共鉴定出5825名痴呆症居民。抗精神病药的年使用率在27.6％至32.6％之间。入院后平均开始时间为308.4天（女性）和173.2天（男性）。甚至在没有精神病合并症的情况下，使用抗精神病药的人中，有65％的人服用了3个月以上；平均年龄（女性）为212.74（95％置信区间：170.24，255.25）天（男性）和216.10（95％置信区间：165.31，266.89）天（男性）。讨论抗精神病药的使用时间通常比建议的时间长。当前的指南和限制可能不足以限制抗精神病药物的使用。