Data from: Antiepileptic drug use and mortality among community-dwelling persons with Alzheimer's disease

Abstract

Objective: To evaluate the risk of death in relation to incident antiepileptic drug use compared with non-use in people with Alzheimer's disease (AD) through the assessment in terms of duration of use, specific drugs and main causes of death. Methods: The MEDALZ cohort includes all Finnish persons who received a clinically verified AD diagnosis (N=70718) in 2005‒2011. Incident AED users were identified with 1-year washout period. For each incident AED user (n=5638) one non-user was matched according to sex, age and time since AD diagnosis. Analyses were conducted with Cox proportional hazards models and inverse probability of treatment weighting (IPTW). Results: Nearly 50% discontinued AEDs within six months. Compared with non-users, AED users had an increased relative risk of death (IPTW hazard ratio (HR): 1.23; 95% CI: 1.12‒1.36). This was mainly due to deaths from dementia (IPTW HR: 1.62, 95% CI: 1.42‒1.86). There was no difference in cardio- and cerebrovascular deaths (IPTW HR: 0.98, 95% CI: 0.67‒1.44). The overall mortality was highest during the first 90 days of AED use (IPTW HR: 2.40, 95% CI: 1.91‒3.03). Among users of older AEDs relative risk of death was greater compared to users of newer AED use (IPTW HR: 1.79, 95% CI: 1.52‒2.16). Conclusions: In old vulnerable population with cognitive disorder, careful consideration of AED initiation and close adverse events monitoring are needed.