Epidemiology and mental illness in old age

Abstract

SUMMARYThis is an overview of epidemiology relevant to mental health problems in old age. We start by reviewing some basic terminology: the definitions of prevalence and incidence; the difference between descriptive and analytical epidemiology; the differences between study designs, including cross-sectional, case–control and cohort studies. We then cover the main epidemiological features of the major psychiatric diseases that affect older people (dementia and its different types, depression, late-onset schizophrenia, bipolar affective disorder, delirium, anxiety-related disorders, eating disorders, alcohol and substance misuse, personality disorders) and suicide.We end with some descriptive statistics regarding quality of life in older people.

How advances in epidemiology are influencing older adult psychiatry

“…Large-scale epidemiological research also provides a unique opportunity to evaluate geographical and temporal differences in disease incidence and prevalence. For example, that the prevalence of dementia in higher-income countries is falling could not be discovered through any other study design (Lilford 2019, this issue).…”

“…As Lilford & Hughes describe (Lilford 2019, this issue), there are many situations where it would be unethical to conduct an RCT. We cannot randomly select and expose a group of people to low educational attainment, or poor diabetic or antihypertensive care, to see whether they acquire higher risk of developing Alzheimer's disease.…”

“…Prevalence of risk factors may also differ by age group. For example, hearing loss appears to be associated with both dementia and schizophrenia, and sensory impairments occur more commonly in older people (Lilford 2019, this issue).…”

Theoretical Investigation of Some Donepezil-based Derivatives as Dual Inhibitors for beta-Amyloid- and Cholinesterase Enzymes

“…The worldwide cost of dementia was estimated at 604 billion USD in 2010 and is expected to increase exponentially. To tackle this problem, it is advisable to develop early detection methods and effective therapeutics (Tappen, 1997;Lilford and Hughes, 2020;Bamidis et al, 2020). AD may also affect patients with noncognitive disorders such as depression anxiety, hallucinations, and delusions (Vicente et al, 2015).…”

“…AD may also affect patients with noncognitive disorders such as depression anxiety, hallucinations, and delusions (Vicente et al, 2015). Although AD pathogenesis is complex and unclear, there are several developed theories, but none of them revealed the specific cause of AD (Lilford and Hughes, 2020;Hardiman et al, 2016). Common targets were identified and explored over the last two decades.…”