Prospective study of tardive dyskinesia incidence in the elderly.
نویسندگان
چکیده
OBJECTIVES To investigate the incidence of tardive dyskinesia in elderly individuals beginning treatment with antipsychotic drugs and to identify risk factors for the development of tardive dyskinesia in the elderly. DESIGN A cohort of previously neuroleptic-naive patients was identified at the time of initiation of antipsychotic drug treatment. Patients were evaluated at baseline and followed up at 3-month intervals for periods ranging from 3 to 119 weeks. SETTING Subjects were recruited from the psychiatric and geriatric medical services of two medical centers, a geriatric institute, and three nursing homes in the metropolitan area of New York City, NY. PATIENTS Two hundred fifteen individuals older than 55 years have entered the study thus far. Preliminary data are presented for 160 patients who were followed up for at least 1 month. Their age range was 57 to 99 years (mean, 77 years). Seventy-two percent were women and 87% were white. Sixty-seven percent of patients had a diagnosis of organic mental syndrome and 42% had a psychiatric diagnosis. INTERVENTIONS A naturalistic, longitudinal, repeated assessment paradigm was employed. Assessments included abnormal involuntary movements, extrapyramidal signs, psychiatric symptoms, and medical and drug treatment histories. MAIN OUTCOME MEASURE The incidence of tardive dyskinesia was determined using a standardized rating instrument and survival analysis. RESULTS The incidence of neuroleptic-induced dyskinesia was 31% (95% confidence interval, 20%, 42%) after 43 weeks of cumulative neuroleptic treatment. Psychiatric (as opposed to organic) diagnosis and presence of extrapyramidal signs early in treatment were associated with increased tardive dyskinesia vulnerability.
منابع مشابه
An investigation on the relationship between risk factors and severity of tardive dyskinesia
The focus of most previous research concerning tardive dyskinesia has been on the impact of risk factors on the development( incidence) of this syndrome. In this paper, we report our results on the relationship between risk factors and the severity of tardive dyskinesia. A total of 33 patients diagnosed as tardive dyskinesia with no other medical illness studied: 21 males and 12 females with a ...
متن کاملProspective study of tardive dyskinesia in the elderly: rates and risk factors.
OBJECTIVE The purposes of this study were to investigate the rate (incidence) of tardive dyskinesia in elderly patients beginning treatment with antipsychotic medication and to identify risk factors for development of tardive dyskinesia in this age group. METHOD A group of 261 neuroleptic-naive patients aged 55 or above were identified at the time they were starting antipsychotic drug treatme...
متن کامل[Tardive dyskinesia in patients with schizophrenia treated with olanzapine - results from a 20-month, prospective, open study under naturalistic conditions].
OBJECTIVES The objective of the study was to assess the prevalence and incidence of tardive dyskinesia in patients treated with olanzapine during the follow-up period of 20 months. METHODS It was a prospective, observational, non-interventional study under naturalistic conditions, without a control group. The evaluation of the severity and presence of tardive dyskinesia was performed with the...
متن کاملFactors related to tardive dyskinesia.
The authors found a 31% incidence of tardive dyskinesia among 261 schizophrenic outpatients treated with neuroleptics. Multiple linear logistic regression analysis revealed a higher incidence of tardive dyskinesia among elderly patients, those with longer records of hospitalization, those for whom neuroleptic medication had little therapeutic effect, and those treated with fluphenazine. Patient...
متن کاملA 6-month longitudinal study of early-onset tardive dyskinesia: association with olanzapine treatment and mild cognitive impairment in an elderly woman.
To the Editors: Tardive dyskinesia (TD) is a common and potentially irreversible hyperkinetic movement disorder resulting from long-term treatment with antipsychotic drugs that are antagonists at dopamine D2 receptors. Tardive dyskinesia is one of the most serious iatrogenic neurological complications of the first-generation antipsychotics. We present a case study of an elderly woman without a ...
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ورودعنوان ژورنال:
- JAMA
دوره 266 17 شماره
صفحات -
تاریخ انتشار 1991