Elderly people with dementia should be prescribed antipsychotics carefully, say Ontario doctors who found men are at higher risk of hospitalization and death than women when the treatment begins.

Little is known about potential differences for risk of serious events between men and women over the age of 85.


Doctors should continue to be vigilant about prescribing drugs to manage dementia in both older men and women, researchers say. (Enrique Castro-Mendivil/Reuters)

Researchers focused on new prescriptions of a class of drugs called atypical antipsychotics that are used to manage behaviour problems associated with dementia.

"It tells us a little bit more about drug therapy and perhaps what might be affecting women and men differently," said Dr. Paula Rochon, a senior scientist at Toronto's Women College Hospital.

In Wednesday's issue of the Journal of the American Geriatric Society, Rochon and her co-authors said of  21,526 older adults with dementia in Ontario who started taking the medications, about seven per cent of the women and nearly 11 per cent of the men died or were hospitalized during the 30 days after the treatment started.

"While younger women may be more likely than younger men to experience an adverse drug event, our results suggest that the incidence of serious events in the elderly is reversed and that older men are more likely than older women to experience a serious event related to atypical antipsychotic initiation," the study's authors concluded.

While the risk of developing a serious event after starting treatment was higher in men than women, Rochon said they're in no way saying doctors should only focus on men. Rather, she said doctors should continue to be vigilant about resorting to prescribing drugs to manage dementia in both men and women.

Since older women outnumber older men in the population, while the rate of the serious events like such as death was higher among men, almost 200 more women than men experienced those, the researchers said.

The results couldn't be explained by traditional risk factors such as age, if the patient was in a long-term care facility compared with at home, other illnesses or dose.

With files from CBC's Amina Zafar