Mental Disorders and the Use of Psychotropic Drugs in an 85-Year-Old Urban Population

Skoog, Ingmar; Nilsson, Lars; Landahl, Sten; Steen, Bertil

doi:10.1017/s1041610293001371

Cited by 112 publications

(101 citation statements)

References 30 publications

(69 reference statements)

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“…Other studies have revealed that many drugs prescribed to elderly people are given for questionable indications, and that the treatment is inadequately followed up (1,4,5,18). This problem also tends to get worse in old age (4,5).…”

Section: Resultsmentioning

confidence: 99%

General practitioners' office consultations with elderly patients – diagnoses and prescriptions: A report from the Møre & Romsdal Prescription Study

Straand¹,

Sandvik²,

Rokstad³

2009

Nor J Epidemiol

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Study objectives: To analyse office consultations with elderly people in general practice: reason for encounter, diagnostic indications for prescribing drugs, and what drugs are prescribed for the different diagnoses. Design: Cross-sectional survey. Setting: The Norwegian county of Møre and Romsdal. Participants: In 1988 and 1989 the general practitioners recorded all encounters with patients over a period of two months. The participation rate was close to 100%, and we report data from 10,850 office consultations with elderly patients (65 years and older). Main results: 60% of the consultations involved female patients, mean age was 74 years. One of three consultations were for new diagnoses, two thirds were follow-ups. The most common diagnostic groups were cardiovascular (28%), musculoskeletal (13%), psychiatric (8%) and respiratory diseases (8%). Almost 10% of all consultations were for hypertension. Drugs were prescribed during 56% of all consultations. 27% of all prescriptions were for cardiovascular drugs, and 25% were for the central nervous system. The 20 most common diagnoses constituted more than half of all the diagnoses, and the ten most common drugs (therapeutic groups) constituted almost 70% of all prescriptions. Conclusion: In the context of quality assurance large benefits may be gained even if focus is put on rather few diagnoses and drugs.

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Section: Resultsmentioning

confidence: 99%

General practitioners' office consultations with elderly patients – diagnoses and prescriptions: A report from the Møre & Romsdal Prescription Study

Straand¹,

Sandvik²,

Rokstad³

2009

Nor J Epidemiol

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“…Among recent studies, prevalences between 6% and 12% have been reported in people aged 65 years and older. [2][3][4] The prevalence was 10.5% in people aged 85 years 7 and 4% in those aged 95 years. 5 The prevalence of GAD ranges between 1% to 10%.…”

Section: Frequency Of Mental Disorders In the Elderlymentioning

confidence: 98%

“…5 The prevalence of GAD ranges between 1% to 10%. 2,3,[19][20][21][22] In people aged 85 years, the prevalence was 6%, 7 and in those aged 95 years, 2%. 5 Few studies have examined the prevalence of OCD among the elderly.…”

Section: Frequency Of Mental Disorders In the Elderlymentioning

confidence: 99%

Psychiatric Disorders in the Elderly

Skoog

2011

Can J Psychiatry

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105

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Recent research has shown that depression, anxiety disorders, and psychosis are more common than previously supposed in elderly populations without dementia. It is unclear whether the frequency of these disorders increases or decreases with age. Clinical expression of psychiatric disorders in old age may be different from that seen in younger age groups, with less and often milder symptoms. Concurrently, comorbidity between different psychiatric disorders is immense, as well as comorbidity with somatic disorders. Cognitive function is often decreased in people with depression, anxiety disorders, and psychosis, but whether these disorders are risk factors for dementia is unclear. Psychiatric disorders in the elderly are often related to cerebral neurodegeneration and cerebrovascular disease, although psychosocial risk factors are also important. Psychiatric disorders, common among the elderly, have consequences that include social deprivation, poor quality of life, cognitive decline, disability, increased risk for somatic disorders, suicide, and increased nonsuicidal mortality.Can J Psychiatry. 2011;56 (7):387-397. Key Words: depression, anxiety, psychosis, elderly, epidemiologic methods, prevalence, risk factors, comorbidityM ost research on mental disorders have been concerned with dementia and to some extent with depression. Other mental disorders, such as anxiety disorders and psychotic disorders, have received less attention. This review will discuss the frequency of mental disorders in the elderly, and its relation to age. Aspects of mental disorders in the elderly without dementia, such as clinical expression and comorbidity, cognitive function and dementia, cerebral neurodegeneration and cerebrovascular disease, and risk factors and consequences, will also be discussed. Frequency of Mental Disorders in the ElderlyThe prevalence of mental disorders is high among the elderly, 1-4 with a prevalence of almost 20% in people without dementia aged 65 years and older.2 While most people in epidemiologic studies are below age 90 years, it was recently reported that almost one-third of people without dementia aged 95 years fulfilled criteria for a psychiatric disorder: 17% had depression, 9% anxiety, and 7% a psychotic disorder. 5Most studies on the epidemiology of mental disorders in the elderly without dementia have been concerned with depression. Cross-sectional studies report prevalence figures of around 5% to 10% for depression, 3,[6][7][8][9][10][11][12] and 1% to 5% for major depression.2,3,13 These figures may be even higher in the developing world.14 This makes depression more common than dementia in people aged 65 years and older. The prevalence of depressive symptoms are even more common than the clinical diagnoses. Such subsyndromal forms of depression are nevertheless associated with adverse outcomes, such as stroke, disability, and mortality. 15-18Anxiety disorders include GAD, agoraphobia, panic anxiety disorder, OCD, social phobia, and specific phobias. Recent research suggests that anxiety disorder...

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“…Lifetime depression included major depressive disorder, dysthymia, and depression not otherwise specified. A diagnosis of dysthymia was made without the two year criterion as information on symptom duration was not specified [22].…”

Section: Psychiatric Examinationmentioning

confidence: 99%