Prospective data on the prevalence of abnormal involuntary movements among elderly people living in the community

Abstract

Trained raters from the Liverpool Continuing Health in the Community study interviewed 1070 people over the age of 65 in 1982-1983 using the Geriatric Mental State (GMS) examination. Three years later the cohort was re-interviewed, this time by psychiatrists trained in the GMS, who used the GMS and the History and Aetiology Schedule (HAS). The cohort had fallen in size to 875, because of mortality; 701 were re-interviewed. The cohort was followed up again 6 years after the first interview by trained nurse raters using the GMS (A3) and the Mini-Mental State Examination. Cases of mental disorder identified by the computer diagnostic program AGECAT were re-interviewed by psychiatrists along with a number of controls using the GMS and the HAS on the remaining 450 individuals. Observational behavioural ratings from the GMS and summary sheets were analysed along with AGECAT diagnoses and data on medication gained at the 3 assessments. The community prevalence of tardive dyskinesia and other movement disorders in elderly people over a 6-year follow-up appears to be very low (the community prevalence of tardive dyskinesia being 0.22% and akathisia 1.57%), is usually associated with organic mental disorder (and consequently higher mortality) and is furthermore not usually associated with antipsychotic medication.

Tardive Dyskinesia--Diagnostic Issues, Subsyndromes, and Concurrent Movement Disorders: A Study of State Hospital Inpatients Referred to a Movement Disorder Consultation Service

“…Thus, the study appears to be unique and is not strictly comparable with the extant literature. Some studies have addressed movement disorder prevalences in special populations incomparable to that of the present study, including children (Richardson et al 1991), patients with particular diagnoses such as mental retardation (Rao et al 1987) or affective disorders (Ghadirian et al 1996), patients on specific drugs (multiple studies), and normal community populations (Green et al 1993). Second, patients were referred for evaluation of suspected TD.…”

“…Other prevalence studies have looked at the sequelae of individual drugs. Still other studies have considered the prevalence of movement disorders in community samples not selected for psychiatric disorders (Green et al 1993). In the present study, drug-induced parkinsonism was quite common, followed by dystonia and akathisia, which is similar to results seen in a sample of 1,107 psychiatric patients (Grohmann et al 1990), despite methodological differences.…”

Variables Associated With Tardive Dyskinesia in Geropsychiatric Outpatients

“…Some researchers have also explored the link between cognitive impairment and T D (Green et a/., 1993;Karson et al, 1990Karson et al, , 1993Wragg and Jeste, 1988). Karson et al (1993) found that TD was associated with cognitive impairment in seven domains in older psychiatric patients who were not diagnosed specifically with an organic mental disorder.…”