Tardive dyskinesia in a chronically institutionalized population of elderly schizophrenic patients: prevalence and association with cognitive impairment.
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 be adequately addressed in this population.


OBJECTIVE
(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.


METHODS
TD was assessed by the Modified Simpson Dyskinesia Scale and cognitive status by the Mini-Mental State Examination (MMSE). The relationship between manifestations of TD 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 < 0.0004) 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.
Neurosciences Treatment Unit, Pilgrim Psychiatric Center, West Brentwood, New York, USA.
W
W
Byne
L
L
White
M
M
Parella
R
R
Adams
P D
PD
Harvey
K L
KL
Davis
D000367:Age Factors; D000368:Aged; D000704:Analysis of Variance; D014150:Antipsychotic Agents / Q000009:adverse effects*; D003072:Cognition Disorders / Q000503:physiopathology; D015331:Cohort Studies; D004198:Disease Susceptibility; D004409:Dyskinesia, Drug-Induced / Q000453:epidemiology* / Q000503:physiopathology; D005260:Female; D006801:Humans; D007326:Institutionalization / Q000706:statistics & numerical data*; D008297:Male; D009518:New York / Q000453:epidemiology; D015995:Prevalence; D012559:Schizophrenia / Q000188:drug therapy*; D012720:Severity of Illness Index
D014150:Antipsychotic Agents