{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T04:52:47Z","timestamp":1791262367983,"version":"4.1.0"},"reference-count":50,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2015,8,27]],"date-time":"2015-08-27T00:00:00Z","timestamp":1440633600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"Retirement Research Fund","award":["2011-107"],"award-info":[{"award-number":["2011-107"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J American Geriatrics Society"],"published-print":{"date-parts":[[2015,9]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>\n                      To assess changes in behavioral symptoms associated with Alzheimer's disease and related dementias (\n                      <jats:styled-content style=\"fixed-case\">ADRD<\/jats:styled-content>\n                      s) after antipsychotic (\n                      <jats:styled-content style=\"fixed-case\">AP<\/jats:styled-content>\n                      ) or antidepressant (\n                      <jats:styled-content style=\"fixed-case\">AD<\/jats:styled-content>\n                      ) treatment and to estimate the effect of treatment response on mortality risk.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Retrospective cohort study using 2006\u20132009 Medicare administrative and prescription drug claims data linked to Minimum Data Set 2.0.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Long\u2010stay (\u2265101\u00a0days) nursing home residents.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>\n                      Continuously enrolled fee\u2010for\u2010service Medicare beneficiaries who had\n                      <jats:styled-content style=\"fixed-case\">ADRD<\/jats:styled-content>\n                      s, initiated (no use in prior 6\u00a0months)\n                      <jats:styled-content style=\"fixed-case\">AP<\/jats:styled-content>\n                      (n\u00a0=\u00a02,035) or\n                      <jats:styled-content style=\"fixed-case\">AD<\/jats:styled-content>\n                      (n\u00a0=\u00a01,661) treatment during or after one or more behavioral symptoms (verbally abusive, physically abusive, socially inappropriate or disruptive behavior) presented, and had reassessment of behavioral symptoms after 3 consecutive months of the initiated treatment.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Measurements<\/jats:title>\n                    <jats:p>Behavioral symptom change was measured according to score (range 0\u20139, based on number and frequency of symptoms) change between baseline and reassessment (improved, &lt;0; unchanged, 0; worsened, &gt;0). Survival analyses were conducted on time to death after reassessment, comparing residents whose symptoms improved with those whose symptoms remained unchanged or worsened.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      <jats:styled-content style=\"fixed-case\">AP<\/jats:styled-content>\n                      s and\n                      <jats:styled-content style=\"fixed-case\">AD<\/jats:styled-content>\n                      s were comparable in treatment effectiveness, as evidenced by more than 85% of the behavioral symptom episodes in each cohort improving or remaining stable. Mortality risk was lower in both cohorts (\n                      <jats:styled-content style=\"fixed-case\">AP<\/jats:styled-content>\n                      : adjusted hazard ratio (\n                      <jats:styled-content style=\"fixed-case\">\n                        aHR\n                        <jats:sub>AP<\/jats:sub>\n                      <\/jats:styled-content>\n                      )\u00a0=\u00a00.93, 95% confidence interval (\n                      <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\n                      ) \u00a0=\u00a00.81\u20131.07;\n                      <jats:styled-content style=\"fixed-case\">AD<\/jats:styled-content>\n                      :\n                      <jats:styled-content style=\"fixed-case\">\n                        aHR\n                        <jats:sub>AD<\/jats:sub>\n                      <\/jats:styled-content>\n                      \u00a0=\u00a00.82, 95%\n                      <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\n                      \u00a0=\u00a00.70\u20130.97) for residents whose symptoms improved than for those whose symptoms unchanged or worsened.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      <jats:styled-content style=\"fixed-case\">AD<\/jats:styled-content>\n                      s may be reasonable pharmacological alternatives to\n                      <jats:styled-content style=\"fixed-case\">AP<\/jats:styled-content>\n                      s in clinical management of\n                      <jats:styled-content style=\"fixed-case\">ADRD<\/jats:styled-content>\n                      \u2010related behavioral symptoms. Initial treatment response may alter medication\u2010associated mortality risk. Further study is needed to confirm findings using other data and behavioral symptom\u2013specific instruments.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jgs.13606","type":"journal-article","created":{"date-parts":[[2015,8,27]],"date-time":"2015-08-27T09:15:08Z","timestamp":1440666908000},"page":"1757-1765","source":"Crossref","is-referenced-by-count":15,"title":["Treated Behavioral Symptoms and Mortality in Medicare Beneficiaries in Nursing Homes with Alzheimer's Disease and Related Dementias"],"prefix":"10.1111","volume":"63","author":[{"given":"Ting\u2010Ying","family":"Huang","sequence":"first","affiliation":[{"name":"Department of Pharmaceutical Health Services Research School of Pharmacy University of Maryland Baltimore Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu\u2010Jung","family":"Wei","sequence":"additional","affiliation":[{"name":"Department of Pharmaceutical Health Services Research School of Pharmacy University of Maryland Baltimore Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patience","family":"Moyo","sequence":"additional","affiliation":[{"name":"Department of Pharmaceutical Health Services Research School of Pharmacy University of Maryland Baltimore Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ilene","family":"Harris","sequence":"additional","affiliation":[{"name":"IMPAQ International LLC Columbia Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Judith A.","family":"Lucas","sequence":"additional","affiliation":[{"name":"Department of Behavioral and Community Health College of Nursing Seton Hall University South Orange New Jersey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linda","family":"Simoni\u2010Wastila","sequence":"additional","affiliation":[{"name":"Department of Pharmaceutical Health Services Research School of Pharmacy University of Maryland Baltimore Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2015,8,27]]},"reference":[{"key":"e_1_2_6_2_1","volume-title":"The Mental Health and Substance Use Workforce for Older Adults: In Whose Hands?","author":"Eden J","year":"2012"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/gps.781"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.288.12.1475"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamda.2010.11.005"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/gps.1489"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2318-5-13"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1017\/S1041610204000468"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1093\/geront\/45.suppl_1.56"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/jgs.12730"},{"key":"e_1_2_6_11_1","volume-title":"A Guide to the Management of Psychotic Disorders and Neuropsychiatric Symptoms of Dementia in Older Adults","year":"2011"},{"key":"e_1_2_6_12_1","first-page":"90","article-title":"Therapeutic approaches in the management of behavioral and psychological symptoms of dementia in the elderly","volume":"55","author":"Drouillard N","year":"2013","journal-title":"B C Med J"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.294.15.1934"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-146-11-200706050-00006"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.JGP.0000200589.01396.6d"},{"key":"e_1_2_6_16_1","volume-title":"Public Health Advisory: Deaths With Antipsychotics in Elderly Patients With Behavioral Disturbances","year":"2005"},{"key":"e_1_2_6_17_1","volume-title":"Information for Healthcare Professionals: Conventional Antipsychotics","year":"2008"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.npp.1301492"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.293.20.2453"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ajp.2007.06101710"},{"key":"e_1_2_6_21_1","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ajp.2013.12030408"},{"key":"e_1_2_6_22_1","first-page":"CD008191","article-title":"Antidepressants for agitation and psychosis in dementia","volume":"2","author":"Seitz DP","year":"2011","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_6_23_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2014.93"},{"key":"e_1_2_6_24_1","unstructured":"CCWdata.org.The Chronic Conditions Data Warehouse[on\u2010line]. 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