Researchers found that in a large national case-control study of more than 139,000 long-stay nursing home residents with Alzheimer disease and related dementias, initiating benzodiazepine or antipsychotic therapy during hospice enrollment was associated with significantly increased 180-day mortality. Among residents without prior exposure, benzodiazepine initiation was linked to a 41% higher hazard of death and antipsychotic initiation to a 16% higher hazard, with propensity score–weighted analyses showing hazard ratios near 2 for both medication classes. A clear dose-response relationship emerged, with each additional filled prescription further increasing mortality risk. Medication initiation occurred early in hospice (median, 3 days after enrollment), and prescribing varied widely across hospice agencies, reflecting practice norms rather than patient characteristics.

Source: JAMA Network Open