Prevalence of Psychotropics Used and Occurrence of Falls Among Older Patients with Parkinson’s Disease

Abstract

Older patients diagnosed with Parkinson's disease (PD) often experience a range of both motor and non-motor symptoms, including psychiatric issues. Managing these patients effectively typically requires a combination of medications, which raises concerns about potential side effects, such as an increased risk of falls. This study aims to explore the prevalence of psychotropic medication use and the occurrence of falls among PD patients aged 65 years and older at a quaternary care center in Malaysia. This retrospective cohort study included all idiopathic PD patients aged 65 years and above who were under follow-up at the interdisciplinary geriatric unit in Hospital Kuala Lumpur from 1^st January to 31^st December 2023. A total of 42 patients were eligible in this study. We collected baseline demographic data, information on psychiatric conditions (e.g., duration, management, and types of psychotropic medications prescribed), and the incidence of falls during the study period. The median age of participants was 75 years (IQR 10), with slightly more males (52%). The median duration of PD was 6 years (SD 5), and 59% of patients were in stages 1 to 3 of the Hoehn and Yahr scale. All participants had comorbidities and were on polypharmacy. Sixty-two percent were diagnosed with a psychiatric disorder, and 77% were prescribed psychotropic medications. The most common psychotropic medications were antidepressants (75%), followed by antipsychotics (15%), anxiolytics (5%), and hypnotics (5%). None had psychotropic polypharmacy. This study highlights the high prevalence of psychiatric disorders, psychotropic medication use, and fall incidents in this population. Regular medication reviews and fall assessments should be integral to the comprehensive geriatric evaluation for PD patients.