Changes in prevalence, severity, and recovery in tardive dyskinesia with age

Advancing age is one of the few factors suggested to predict increased risk of tardive dyskinesias (TDs). By pooling and reanalyzing available epidemiological data, we found strong linear correlations between ages (< 40 to 70 years) and both the prevalences and severity of TD, while neither increased significantly after age 70 years. There was also a strong inverse correlation between rates of spontaneous remission of TD and age (< 30 to > 80 years); TD in those younger than 60 years improved over three times as often as in older patients. These correlations are not readily explained by the duration of previous exposure to neuroleptic drugs and may reflect increased sensitivity of the aging brain to them. These observations support caution in the prolonged use of neuroleptics in patients older than age 50 years but encourage optimism for eventual spontaneous remission of TD in young adults.