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Background: during the dementia time course Behavioral and Psychological Symptoms of Dementia (BPSD) may arise. Despite their use is still off‐label and they are associated with several side effects, antipsychotics represent the main pharmacological strategy to alleviate BPDS Method: aim of this retrospective study was to evaluate the correlation between antipsychotics use and all‐cause mortality. BPSD were classified in three clusters: "mood/apathy", "psychosis" and "hyperactivity". ANOVA for repeated measures was used to evaluate the functional/cognitive changes over three time points (baseline, 6 months and 12 months follow‐up). Chi‐Square test was carried out to verify the correlation between antipsychotic drug use and mortality. Logistic regression and stepwise regression method were used to analyze the relationship between mortality and other potential influencing factors, including ADL, IADL, CFS, in addiction of antipsychotics drugs use. Result: a total of 209 patients with a clinical diagnosis of dementia were enrolled (71.3% women; mean age = 83.24±4.98 years). The results of the ANOVA indicated a significant worsening of ADL and IADL over time [ADL Wilks' Lambda = 0.744, F(2,80) = 13.75, p<0.001, η2 = 0.256, IADL Wilks' Lambda = 0.71, F(2,80) = 16.3, p<0.001, η2 = 0.29, respectively], a significant progression of cognitive impairment as measured with MMSE and a significant worsening in frailty at CFS at 6 and 12 months follow up [MMSE Wilks' Lambda = 0.751, F(2,73) = 12.11, p<0.001, η2 = 0.249, CFS Wilks' Lambda = 0.749, F(2,79) = 13.224, p<0.001, η2 = 0.241]. Patients on antipsychotic therapy reported a higher mortality rate, although there is no statistically significant association between antipsychotic use and mortality. We found no significant correlation between mortality and antipsychotic drug use within the different BPSD cluster ("mood/apathy" p = 0.464, "psychosis" p = 0.569, "hyperactivity" 0.528), and no statistically significant association between mortality and other potential influencing factors. Using a stepwise regression, the loss of independence in IADL survived as factor associated to mortality (p = 0.002). Conclusion: patients on antipsychotic therapy reported a higher mortality rate, although there is no statistically significant association between antipsychotic use and mortality. Further work is needed to establish the relationship between antipsychotics and mortality in elderly patients with dementia. [ABSTRACT FROM AUTHOR]

Background: dementia is a clinical syndrome characterized by progressive cognitive decline and loss of independence in activities of daily living. Alongside the cognitive symptoms, Behavioral and Psychological Symptoms of Dementia (BPSD) may arise, causing considerable distress to both patients and caregivers Method: aim of this retrospective study was to evaluate the correlation between frailty and BPSD in a population of older patients with dementia. BPSD were classified in three clusters: "mood/apathy", "psychosis" and "hyperactivity". Using the Clinical Frailty Scale (CFS), patients were categorized as "severely frail", "mild/moderately frail" and "robust" (CFS ≥ 7, 4‐6 and ≤ 3, respectively). In order to better understand the complex pattern of relationships between the different factors, we performed a network analysis. Result: 209 patients (71.3% women, mean age 83.24±4.98 years) with a clinical diagnosis of dementia were enrolled. The most represented group was the mild/moderately frail one (n = 155, 74%); lower numbers were seen in the robust (n = 18, 9%) and severely frail (n = 36, 17%) ones. Among the "severely frail" the percentage of BPSD was higher compared to the "mild/moderate" and "robust" groups. A significant correlation between frailty and "hyperactivity" cluster emerged, both at baseline and follow up visits (p<0.001, p = 0.022, p = 0.028 respectively). At the network analysis, the degree of frailty related to behavioral and psychological symptoms of the hyperactivity cluster, such as agitation and motor aberrant activity; the relationship was still positive although not so strong with other symptoms like apathy and hallucinations. Conclusion: in this study an association between frailty and the number of neuropsychiatric symptoms of the "hyperactivity" cluster was found; however, whether the loss of independence is a possible cause of frailty or viceversa is still to be determined. The assessment of frailty may help identifying patients at risk of developing behavioral and psychological symptoms of dementia, and could provide the clinicians with a time‐window to target intervention in the earliest phases of both frail condition and BPSD. [ABSTRACT FROM AUTHOR]