Antipsychotic Use in Older Adults with Dementia: Community and Nursing Facility Trends in Texas, 2015-2020.

The study cannot show why antipsychotic use changed, because it only looked at patterns over time in claims data. A filled prescription was counted as use, but the data did not show that the person actually took the medication. Dementia status and residential status came from Medicare codes, not clinical records, so dementia severity, exact dementia type, length of stay, and assisted living status were not well captured. Neighborhood deprivation was based on mailing ZIP code, which may not be where the person actually lived. The findings are from Texas Medicare fee-for-service beneficiaries from 2015 to 2020 and may not apply to other states, Medicare Advantage plans, or current prescribing. The study period did not include years after brexpiprazole was approved for agitation in Alzheimer's disease, so it cannot show how that changed prescribing.

The authors declared no conflicts of interest. The supplied publication types list non-U.S. government and NIH extramural research support, but the article text does not state the funder's role in design, analysis, or writing.

Do not read the decline as proof that antipsychotics were stopped safely or that the trend will continue. This was an observational claims study from Texas Medicare data, and it cannot establish cause or confirm that medications were actually given.