The Epidemiology of Psychological Problems in the Elderly

Abstract

Objective: To determine the prevalence of mood, anxiety, and other disorders in the population of Canadians aged 55 years and over. Method:We undertook an analysis of the Canadian Community Health Survey: Mental Health and Well-Being (CCHS 1.2).Results: There was a linear decrease for all disorders after age 55 years. This was true for men and women; for anglophones, francophones, and allophones; and for both people born in Canada and people who immigrated to Canada after age 18 years. Consistent with previous research, the prevalences were higher for women than men. Immigrants reported fewer problems than nonimmigrants, with the differences decreasing with age. Francophones of both sexes reported more mood disorder than anglophones, but francophone men had less anxiety disorder than anglophone men. Conclusions:Unlike other studies that have found an upturn in the prevalence of depression and anxiety in the elderly, our results indicate a steady decrease in these disorders. Our findings are discussed in terms of explanations for age-related differences in psychiatric disorders. Clinical Implications· Although people aged 55 years and over are more prone to suffer physical ailments and are more likely to face loss of loved ones, they appear to suffer less anxiety and depression than those aged of 55 years and under. · The low estimates of psychiatric disorders among the elderly, combined with the widely held belief that depression and other disorders are common in this population, suggest that there may be some risk of misattributing physical distress or impairment to psychological factors, leading to overmedication. Further research regarding the prevalence of mood and anxiety disorders among the elderly in institutions is required as this is an understudied group. Limitations· Although the CCHS 1.2 used a well-validated interview schedule, diagnoses are based on self-report of symptoms and were not confirmed by clinical interviews. · Not all depressive or anxiety disorders were included in the survey, although the most prevalent were. · The response rate was quite high for surveys, but those who did not participate may have refused because of psychological problems, possibly lowering the prevalence rates. · People in long-term care facilities and hospitals were not included.

The Social Epidemiology of Affective and Anxiety Disorders in Later Life in Canada

“…Finally, the negative effect of age on disorder, 31 the nonsignificance of sex differences, 12,13,32 and the lower prevalence of disorder observed in French-speaking Canadians 16 have been reported before in this population. Several explanations, including cohort effects, selective attrition, methodological problems, age-related hormonal changes, and other aging differences have been offered for declining prevalence of disorder with age and for the disappearance of the gender gap that is invariably found among younger adults.…”

Anxiety disorders in older adults: a comprehensive review

“…Nationally representative (US) [93] (NESARC) Cairney [22] (CCHS) Corna [33] (CCHS) Streiner [166] ( Schaub and Linden [6] 516 Representative community sample…”

Official Language Minority Communities in Canada: Is Linguistic Minority Status a Determinant of Mental Health?

“…This contrasts with previous work which has shown that individuals with poor language proficiency have higher rates of depression, anxiety, and substance abuse compared to those with good to excellent language proficiency. [2][3][4] However, in these studies participants had at least limited English skills and data collection took place in the United States where there is a pre-eminence of English as an "official language". In contrast, the current study was unable to assess English or French language proficiency and took place in Canada where two official languages exist.…”

“…For instance, some linguistic minority groups have been shown to have an increased risk for poor mental health. [2][3][4] However, it should be noted that the relationship between language and mental health outcomes has been inconsistent. [5][6][7][8] This may be attributed to the fact that research occurring in Canada and the United States has almost exclusively focused on visible minority groups or immigrants as a proxy for language use.…”