DETERMINANTS OF SPONTANEOUS EXTRAPYRAMIDAL SYMPTOMS IN ELDERLY PSYCHIATRIC-INPATIENTS DIAGNOSED WITH ALZHEIMERS-DISEASE, MAJOR DEPRESSIVE DISORDER, OR PSYCHOTIC DISORDERS

Extrapyramidal symptoms (EPS) occur more frequently in demential of th e Alzheimer's type (DAT) than in normal aging. Other late-life mental disorders, however, have also been associated with EPS. To examine whe ther EPS are increased in DAT patients relative to neuropsychiatric co ntrol subjects, the authors compared EPS in 127 neuroleptic-free elder ly patients diagnosed with either DAT, major depressive disorder (MDD) , or a psychotic disorder (SCHIZ/DELUS). They also examined whether de pressive or psychotic symptoms were associated with EPS independently of diagnosis. Severity of parkinsonian rigidity was found to be indepe ndently associated with DAT. Rank order of rigidity was DAT>MDD>SCHIZ/ DELUS. Bradykinesia, although not associated with diagnostic group, wa s positively correlated with withdrawn depression. These findings sugg est that rigidity is associated with DAT independently of any concurre nt psychotic or depressive process, whereas bradykinesia does not appe ar to be specific to DAT among late-life neuropsychiatric illnesses.