Purpose: To explore the impact of possible tardive dyskinesia (TD) in a real-world population of older patients (≥55 years).
Rationale: Older age is a risk factor for developing TD (DSM-5, 2013), a persistent and potentially disabling movement disorder associated with prolonged exposure to antipsychotics. In older patients, TD symptoms may appear after shorter antipsychotic treatment.
Methods: In RE KINECT (NCT03062033), adult psychiatric outpatients with ≥3 months of lifetime exposure to antipsychotics and ≥1 psychiatric disorder were assessed for possible TD based on clinicians’ observation and evaluation (“none”, “some”, or “a lot”) of involuntary movements in 4 body regions: head/face, trunk/neck, upper extremities, and lower extremities. Patients were categorized into cohort 1 (without visible movements or possible TD) or cohort 2 (with visible movements and confirmed by clinician as consistent with possible TD). Baseline outcomes for all patients included demographics, clinical history, patient-reported health status, and the patient-reported EuroQoL 5 dimensional 5-level questionnaire (EQ-5D-5L). Exploratory statistical testing was conducted between older adults (≥55 years) in cohorts 1 and 2.
Results: 739 patients were enrolled in the study; results for those ≥55 years (N=300, 41%) are presented. Within this older subgroup, 114 (38%) had clinician-confirmed possible TD (cohort 2) and 186 (62%) had no visible movements or had non-TD movements (cohort 1). In older cohort 2 patients, severe abnormal movements (rating=“a lot”) were most frequently observed in head/face (25%) and upper extremities (14%). Compared to older cohort 1 patients, fewer cohort 2 patients were married (23% vs 34%), more were living in care homes (22% vs 11%), and lifetime exposure to antipsychotics was longer (19.1 vs 12.2 mean years); all P