Published online Feb 19, 2022. doi: 10.5498/wjp.v12.i2.348
Peer-review started: May 30, 2021
First decision: July 14, 2021
Revised: July 27, 2021
Accepted: January 20, 2022
Article in press: January 20, 2022
Published online: February 19, 2022
Processing time: 262 Days and 23.3 Hours
Catatonia in older people is an underrecognized and undertreated systemic medical syndrome despite having specific treatment that has shown great effectiveness. These patients are at increased susceptibility of developing potentially life-threatening complications.
Systematic reviews on this topic have not been conducted. Similar previous reviews were not systematic, and since their publication, the number of papers in this regard has practically doubled. We considered that an update was necessary.
This review aimed to synthesize all the published literature related to catatonia in older patients. This summary will provide up-to-date knowledge about this condition.
A comprehensive systematic review was conducted according to PRISMA recom-mendations. An extensive search strategy was developed, and the MEDLINE, EMBASE, and PsycINFO databases were searched. Screening was completed in duplicate. Papers that investigated issues related to catatonia and/or catatonic symptoms in older people with an English abstract available were included. Additionally, we provided all the clinical correlates of our series of catatonia in a psychogeriatric ward.
In total, 173 articles were considered in this systematic review. Most of them were case reports and case series (143), and only 11 were prospective cohort studies. Catatonia in older people is highly prevalent, and in most cases, its etiology is multifactorial. Neurological disorders could play a very important role in catatonia development; in part, cardiovascular risk factors could explain this association. BZDs and ECT are very effective and well tolerated treatments.
This systematic review provides a comprehensive summary of catatonia in older people. These patients have a higher risk of developing catatonia than younger patients with BD in the general hospital and secondary to BZD withdrawal. Age is related, within other risk factors, to poor NMS prognosis and the development of complications.
The current review revealed that the number and quality of studies on this issue are scarce. Given the high morbidity of catatonia in older people, prompt identification and treatment are essential. Thus, further prospective research is warranted to more accurately identify all the clinical aspects of catatonia in older people.