PROSPECTIVE-STUDY OF TARDIVE-DYSKINESIA IN THE ELDERLY - RATES AND RISK-FACTORS

Objective: The purposes of this study were to investigate the rate (in cidence) of tardive dyskinesia in elderly patients beginning treatment with antipsychotic medication and to identify risk factors for develo pment of tardive dyskinesia in this age group. Method: A group of 261 neuroleptic-naive patients aged 55 or above were identified at the tim e they were starting antipsychotic drug treatment. This group is the c omplete study group; a preliminary report based on the first 160 patie nts was published previously. Patients were evaluated at baseline and followed up at 3-month intervals for periods ranging from 3 to 393 wee ks. Assessments included abnormal involuntary movements, extrapyramida l signs, psychiatric symptoms, and medical and drug treatment historie s, Results: The cumulative rates of tardive dyskinesia were 25%, 34%, and 53% after 1, 2, and 3 years of cumulative antipsychotic treatment. A greater risk of tardive dyskinesia was associated with history of E CT treatment, higher mean daily and cumulative antipsychotic doses, an d presence of extrapyramidal signs early in treatment. Differences in tardive dyskinesia rates between diagnostic groups found in univariate analyses were attenuated when the authors controlled for these variab les. Conclusions: Tardive dyskinesia rates for patients beginning trea tment with conventional antipsychotics in their fifth decade or later are three to five times what has been found for younger patients, desp ite treatment with lower doses. Alternative treatments need to be inve stigated.