1. Initiating benzodiazepines or antipsychotics at hospice enrollment was associated with significantly increased 180-day mortality in patients with Alzheimer disease and related dementias.
2. Benzodiazepine initiation was linked to a 41% higher hazard of death and antipsychotic initiation to a 16% higher hazard, with weighted models yielding hazard ratios near two for both.
3. Each additional filled prescription further increased mortality risk, suggesting cumulative exposure meaningfully contributes to adverse outcomes.
4. Use of these medications varied dramatically across hospice agencies, driven more by agency norms than patient characteristics.
5. Findings highlight the need for standardized prescribing guidance and closer monitoring of psychotropic use, especially as many patients with dementia live beyond the 6-month hospice eligibility period.

Source: JAMA Network Open