High prevalence of movement disorders in the community

There is a substantial under-recognition and under-treatment of movement disorders in the general community, according to authors of a population-based study.The Italian study involved 706 men and women aged 50-89 years who were part of an ongoing prospective study of carotid atherosclerosis and stroke risk in northern Italy (the Bruneck study). The investigators undertook a thorough neurological assessment of the cohort and used standard criteria and scales to diagnose movement disorders and assess disease severity.The study found that the prevalence of movement disorders was similar in men and women and increased with age from around 19% in the 50-59-year age group to 51% in the 80-89-year age group. Disease severity was rated as moderate-to-severe in 42% of all individuals diagnosed with a movement disorder, and in 56% of individuals if exaggerated physiological postural tremor was excluded from the analysis. However, only 7% of individuals with a movement disorder had received treatment. The most common movement disorders were tremor (14.5%), restless leg syndrome (10.8%) and parkinsonism (7%). Other disorders included primary dystonia and secondary dystonia (1.8%), and chorea and tics (In the five years before assessment, 33 individuals had received neuroleptics for at least 6 months of which 16 (49%) had developed a movement disorder. The authors note, "In most instances, equally effective alternative treatments would have been available. Our findings draw attention to the substantial harm associated with the frequent use of neuroleptics and low-dose neuroleptic supplements in the community."The authors say their data shows that most patients still do not receive adequate treatment for movement disorders, and that around a fifth of movement disorders, being drug-induced, are potentially avoidable. They add, "The results of our study should increase alertness among clinicians and health authorities to the high prevalence and associated disease burden of movement disorders in the general community aged older than 50 years."Reference...