Tardive dyskinesia in a chronically institutionalized population of elderly schizophrenic patients: Prevalence and association with cognitive impairment

Author(s): White, L., Parella, M., Adams, R., Harvey, P. D., Davis, K. L.

Journal/Book: Int J Geriat Psychiat. 1998; 13: Baffins Lane, Chichester, W Sussex PO19 1UD, England. John Wiley & Sons Ltd. 473-479.

Abstract: Background. Chronically hospitalized geriatric inpatients with schizophrenia are at particular risk for both tardive dyskinesia (TD) and cognitive impairment but have been insufficiently studied in this regard. Similarly, the relationship between TD and cognitive impairment has not been adequately addressed in this population. Objectives. (1) To determine the prevalence of TD in a cohort of chronically institutionalized schizophrenic geriatric inpatients. (2) To examine the relationship between the manifestations of TD in various body regions and several potentially related variables including current pharmacological regimen, age, age at first hospitalization and cognitive status. Method. TD was assessed by the Modified Simpson Dyskinesia Scale and cognitive status by the Mini-Mental State Examination (MMSE). The relationship between manifestations of TDI and other variables was examined by t-tests, ANOVA, MANOVA and correlational analysis. Results. The prevalence of TD was 60%. Prevalence increased with age but was not related to current antipsychotic or anticholinergic regimen. Mean MMSE score did not differ between groups of patients with and without TD as defined by the criteria of Schooler and Kane (1982); however, the mean MMSE score was significantly (p < 0.004) lower in subjects with orofacial TD as defined by Waddington and Youssef(1996), and the difference was not entirely accounted for by the older age of the latter group. Conclusions. TD and cognitive impairment both increase with age. However, TD alone does not account for the severity of cognitive impairment in this population. The present study provides further support for the hypothesis that the correlation between TD and cognitive impairment holds primarily for the orofacial manifestations of TD.

Note: Article Byne W, CUNY Mt Sinai Sch Med, Dept Psychiat, Box 1230, 1 Gustave Levy Pl, New York,NY 10029 USA

Keyword(s): mental disorder; schizophrenia; tardive dyskinesia; dementia; old age; RISK-FACTORS; DYSFUNCTION; DOPAMINE; SEVERITY; SYMPTOMS; DYSTONIA; STATE

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