Catatonia in older adults: A systematic review

Table 1 Catatonia in a United Kingdom acute psychogeriatric ward

Abstract
Aims	To determine the frequency and characteristics of catatonia in older people in a psychogeriatric ward
Methods	All patients admitted were screened for catatonia with the Bush-Francis Catatonia Screening Instrument over a period of 6 mo. Data was collected on sociodemographics, past medical/psychiatric/drug history, clinical findings, treatment, complications/outcome, and investigations. Treatment with lorazepam orally or intramuscularly was initiated in patients who fulfilled diagnostic criteria for catatonia
Results	37 patients were admitted. Prevalence of catatonia was 27%, 10 out of 37 (Bush-Francis criteria) and 24.3%, 9 out of 37 (DSM-5 criteria). The 10 catatonic patients have a mean age of 75.8 years; range: 67-87; and 8 were female. 90% of these patients had a cardiovascular risk factors. The etiology was multifactorial in 50% of the cases. 6 patients had dementia. In 3 of them catatonia was associated with the use of neuroleptics, in 1 with neuroleptics and a urinary infection (she also had delirium), in another with major depression and in only one dementia was a possible etiology. 40% of the cases developed catatonia secondary to affective disorders and 10% to schizophrenia spectrum disorder. In the total sample there were 14 patients with dementia. The catatonia rate in these patients was 42.8% (6 of 14). 9 patients received treatment for catatonia with lorazepam, all of which achieved complete remission, 1 of the these was also treated with clonazepam. 1 patient was treated with sodium valproate and achieved a partial response. 3 patients developed complications secondary to catatonia. One had an elevated creatine kinase of 1083 IU/L, another a deep venous thrombosis, and the last one, hypokalemia
Conclusions	Catatonia is a very prevalent entity in the psychogeriatric ward. The etiology is usually multifactorial. This condition occurred frequently in patients admitted with dementia. Treatment with lorazepam is highly effective and safe

DSM-5: Diagnostic and Statistical Manual - Fifth Edition.