Parkinsonism and exposure to neuroleptic drugs in elderly people living ininstitutions

Three-hundred fifty-two randomly selected residents, aged over 65 years, of 42 representative long-term care institutions in a defined geographic area of southwestern France, were assessed for demographic characteristics, dru g intake, and motor and cognitive status. Neuroleptic drug intake is descri bed and demographic variables and motor and cognitive status are analyzed a ccording to exposure to neuroleptics and presence of parkinsonism. Exposure to neuroleptics was considered as a ''risk factor'' for parkinsonism, and the risk (proportion) of parkinsonism attributable to neuroleptics calculat ed. Twenty-one percent of subjects were exposed to neuroleptics, of whom 27 % took more than one. Subjects taking neuroleptics were significantly young er and more cognitively impaired. About 30% of subjects taking neuroleptics had parkinsonism (6.25% of the sample). Postural and action tremors were m ore frequent than resting tremor, and asymmetry of parkinsonian signs was f ound in 25%. The mean dosage taken by exposed subjects with parkinsonism wa s found to be twice that of those without. The proportion of cases of parki nsonism attributable to neuroleptics in institutions was 19%. Our results c learly show that neuroleptic drug use in institutionalized elderly persons is associated with a high risk for parkinsonism.