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33, -5.56-1.10, p=0.003 for DAD) and 18 months (β 1.41, 0.16-2.67, p=0.027 for CDR-Sb/β -3.86, -6.64 to -1.08, p=0.006 for DAD). APOE ε4 carriers experienced significantly greater cognitive decline with long-term antipsychotic use. Long-term antipsychotic use was associated with greater cognitive decline and dementia progression in community-dwelling older adults with mild-moderate AD. Our findings are consistent with previous evidence encouraging cautious and careful consideration of risks versus benefits of antipsychotic usage in those