Long-term antipsychotic use, orthostatic hypotension and falls in older adults with Alzheimer’s disease

Key summary points Aim We assessed longitudinal relationships between long-term antipsychotic use, orthostatic hypotension and falls/syncope in older adults living with mild-to-moderate dementia due to Alzheimer disease (AD). Findings Over 18 months, long-term antipsychotic use in older adults with dementia due to AD was associated with a greater likelihood of experiencing sit-to-stand orthostatic hypotension (ssOH), measured on eight separate study visits. Both ssOH and antipsychotic use were independently associated with incident falls/syncope over 18 months. Message Our findings provide supportive evidence that long-term antipsychotic use is associated with both ssOH and falls/syncope in older adults with mild–moderate dementia due to AD—highlighting the need for medication review and screening for symptoms of OH/falls/syncope in older adults with AD prescribed these medications.