Psychiatric symptoms are not an independent mortality risk factor in community-living elderly people

ABSTRACTBackground:Mortality risk factors have attracted great research interest in recent years. Physical illness is strongly associated with mortality risk in elderly people. Furthermore, a relationship between mortality risk and psychiatric disease in the elderly has gained research interest.Methods:This is a prospective longitudinal multicenter study. A sample of 324 participants was selected as a representative sample of community members aged 65 years and older and living in Huesca (Spain). The following information was collected: affiliation data, severity of physical illness, psychosocial, and psychiatric factors. Statistical analyses were completed with a multivariate analysis in order to control possible confounding variables related to mortality.Results:Of the initially selected sample, 293 participants were assessed. Sixty-four participants died (21.8%, 95% CI [16.9%, 26.7%]), 5.3% annual rate, and 46.1% showed symptomatology of mental disorders. Older people have eight times greater risk of mortality. The risk increased 53 times in patients affected by several physical illness. No relationship between cognitive dysfunction and depressive symptomatology was observed. In fact, physical condition was associated with depression, and the percentage of participants with depressive symptoms increased according to the severity of physical illness.Conclusions:Severity of physical illness and age are independently and directly associated with mortality in the elderly people. Therefore, severity of physical illness seems to be a crucial factor in the bi-directional association between mortality and depression, acting as a risk factor independently for both. So the relationship between depression and mortality can be affected by the severity of physical illness.

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Treating chronically psychotic patients in nursing homes

European Psychiatry ◽

10.1016/j.eurpsy.2016.01.875 ◽

2016 ◽

Vol 33 (S1) ◽

pp. S37-S37 ◽

Cited By ~ 1

Author(s):

J. Gauillard

Keyword(s):

Nursing Home ◽

Psychotic Disorders ◽

Psychiatric Symptoms ◽

Psychiatric Hospitals ◽

The Elderly ◽

Sheltered Housing ◽

Psychiatric Disease ◽

Public Health Issue ◽

Old Patients ◽

Alzheimer Dementia

The increase of aging patients with schizophrenia becomes a public health issue. The exponential demography of the elderly, the improvement of cares associated with better physical follow-up directly impact the number of old patients with chronic psychiatric disease. Deinstitutionalization associated with a dramatic enhancement of ambulatory and community cares has led to a reduction of beds in psychiatric hospitals. When dependency occurs, due to physical comorbid illness or a worsening of the negative symptoms, psychiatric teams should find appropriate housing and no longer the psychiatric hospital. Nursing home and sheltered housing for the elderly dependent persons become a solution, but geriatric staffs are not always prepared to receive resident with schizophrenia and other psychotic disorders. They often are at a loss when faced with the expression of psychiatric symptoms or with the specificity of caring for often-younger patients whose behavior is different from older people with neurodegenerative disorders.How psychiatric teams could long-term assist the sheltered housing and nursing home and bring a psychiatric know-how within staffs often reluctant to deal with psychotic patients who could burden caregivers. How could they be trained to cope with complex cognitive functions impairments of schizophrenia, far from cognitive impairments of Alzheimer dementia? How to change the representation of psychiatric illness, which often leads to a double stigmatization (old age and madness)? Improving the quality of life of aging patients with severe chronic mental illness in homes for seniors is a great challenge for psychiatric teams in collaboration with geriatric caregivers.Disclosure of interestThe author has not supplied his declaration of competing interest.

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Lifestyle, Nutritional Status, Health, and Mortality in Elderly People Across Europe: A Review of the Longitudinal Results of the SENECA Study

The Journals of Gerontology Series A ◽

10.1093/gerona/59.12.1277 ◽

2004 ◽

Vol 59 (12) ◽

pp. 1277-1284 ◽

Cited By ~ 107

Author(s):

Lisette C. P. M. G. de Groot ◽

Marieke W. Verheijden ◽

Stefaan de Henauw ◽

Marianne Schroll ◽

Wija A. van Staveren

Keyword(s):

Elderly People ◽

Mortality Risk ◽

Healthy Aging ◽

Healthy Lifestyle ◽

Functional Dependence ◽

The Elderly ◽

Lifestyle Factors ◽

Unhealthy Lifestyle ◽

Geographical Differences ◽

Geographical Patterns

Abstract This article provides an overview of the longitudinal Survey in Europe on Nutrition and the Elderly: a Concerted Action (SENECA) study, which was designed to assess differences in dietary and lifestyle factors among elderly Europeans, and to identify the factors that contribute to healthy aging. Elderly people from Belgium, Denmark, France, Italy, Portugal, Spain, Switzerland, and The Netherlands participated in the SENECA study. Standardized measurements were conducted at baseline in 1988–1989 and were repeated in 1993 and 1999. Diet, physical activity, and smoking, as well as maintenance of health and survival, were assessed. At baseline, considerable differences in lifestyle factors existed among elderly people. Mealtime patterns as well as dietary intake varied across Europe, and geographical patterns were apparent. Similar results were found for engagement in sport or professional activities. The smoking prevalence among women was generally low. Distinct geographical differences were also observed in percentages of deaths during the SENECA study and in overall survival time. A healthy lifestyle was related to stable self-perceived health, a delay in functional dependence, and mortality. Inactivity and smoking, and to a lesser extent a low-quality diet, increased mortality risk. A combined effect of multiple unhealthy lifestyle factors was also observed. The SENECA study showed that a healthy lifestyle at older ages is related to a delay in the deterioration of health status and a reduced mortality risk. Improving and maintaining a healthy lifestyle in elderly people across Europe is a great challenge for the European Community.

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Depression, physical illness and mortality in a Spanish community-dwelling elderly people

European Psychiatry ◽

10.1016/j.eurpsy.2016.01.423 ◽

2016 ◽

Vol 33 (S1) ◽

pp. S189-S189

Author(s):

J. Olivera-Pueyo ◽

S. Benabarre-Ciria ◽

T. Lorente-Aznar ◽

M. Rodríguez-Torrente ◽

C. Pelegrín-Valero ◽

...

Keyword(s):

Multivariate Analysis ◽

Cognitive Impairment ◽

Elderly People ◽

Functional Impairment ◽

Rating Scale ◽

Physical Illness ◽

Community Dwelling ◽

Bivariate Analysis ◽

Physical Factors ◽

Prospective Longitudinal

ObjectivesThe aim of this study is to investigate the association between depression, physical factors and mortality in elderly people living in the community.MethodsProspective longitudinal multicenter study for 5 years. Cohort of 293 people aged 65 years and older living in the province of Huesca (Spain). Individual face-to-face interviews and with appropriate caregiver. The following information was collected:– demographic data;– psychosocial factors: sex, age, education, marital status, live-in family members, social relationships, life events;– physical factors: severity of physical illness, comorbidity (Cumlative Illness Rating Scale);– psychiatric factors: cognitive function (Spanish version of Mini-Mental State Examination), depression (Geriatric Depression Scale), diagnostic criteria according DSM-IV-TR.Statistical analyses:– a bivariate analysis;– a multivariate analysis. Cox regression model (explanatory variables).ResultsTwo hundred ninety-three participants, simple representative of people aged 65 years old or more in province of Huesca (Spain). Monitored 5 years follow-up study. Sixty-four people died (21.8%), annual mortality rate: 5.3%. Depression: 66 people (22.5%), (32.2% women, 13.3% men). Cognitive impairment: 51 people (17.4%). Bivariate: factors associated (P < 0.005) with mortality: functional impairment, living in nursing home, sensorial impairment, polypharmacy, severe physical illness and psychiatric comorbidity: depression (34.8 vs 18.1%), cognitive impairment (49.1 vs 15.8%). Association between some factors and mortality was nullified after multivariate statistical model; the case for depression (Hazard Ratio: 1.1), cognitive impairment (HR: 1.2) or functional impairment (HR: 1.3).ConclusionsDepression and cognitive impairment are associated with mortality in elderly community living people in bivariate analysis, therefore, this association disappears after multivariate analysis. Severity physical illness seems to nullify the effect of other variables, such as depressive symptomatology.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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Orosomucoid: a mortality risk factor in elderly people living in the community?

Clinical Nutrition ◽

10.1054/clnu.2002.0534 ◽

2002 ◽

Vol 21 (1) ◽

pp. 45-50 ◽

Cited By ~ 10

Author(s):

A. RAYNAUD-SIMON ◽

S. LAFONT ◽

C. BERR ◽

J.F. DARTIGUES ◽

Y. LE BOUC

Keyword(s):

Risk Factor ◽

Elderly People ◽

Mortality Risk

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Medical Illness, Suicide, and Assisted Death

10.1093/oxfordhb/9780199352722.013.28 ◽

2015 ◽

Author(s):

Phillip M. Kleespies

Keyword(s):

Risk Factor ◽

Assisted Suicide ◽

The Elderly ◽

Physical Illness ◽

Medical Illness ◽

Functional Impairments ◽

Assisted Death ◽

Competent Patient ◽

Increased Risk ◽

The Right

Because of their focus on psychopathology, mental health clinicians may overlook the potential significance of medical illness as a risk factor for suicide. In this chapter, the author presents evidence that physical illness, particularly certain physical illnesses, can be independent risk factors for suicide. In a number of these illnesses, depression is clearly a confounding risk factor, while in others the illness itself or its consequent functional impairments may lead to increased risk. When an individual has multiple physical illnesses, as often happens with the elderly, the cumulative burden can become overwhelming and heighten the risk of suicide. When physical illness becomes terminal, the competent patient has the right to refuse life-sustaining treatment. Whether that individual can receive assistance in dying has been more controversial. The chapter concludes with a presentation of data from a state where assisted suicide, also known as assisted death, has been legalized.

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The relationship between sleep disturbance and morale in Japanese elderly people

International Psychogeriatrics ◽

10.1017/s1041610205001560 ◽

2005 ◽

Vol 17 (3) ◽

pp. 443-449 ◽

Cited By ~ 1

Author(s):

Atsushi Ichimiya ◽

Ruriko Igata ◽

Koji Ogomori ◽

Tomohide Igata

Keyword(s):

Sleep Disturbance ◽

Elderly People ◽

Psychiatric Symptoms ◽

Negative Attitude ◽

The Elderly ◽

Negative Attitudes ◽

Elderly Individuals ◽

Disturbed Sleep ◽

Japanese Elderly ◽

Sleep Sex

Background: Complaints of sleep disturbance are common in elderly individuals. The quality of life (QOL) for people who have insomnia is thought to be worse than for those who do not have insomnia. In this study we investigated the influence of disturbed sleep on morale in elderly people who live independently.Methods: A survey of the necessity of public nursing care for all those aged over 65 years was performed in Kumamoto city, Japan. Three hundred subjects from the elderly population living at home without special care were sampled at random and they filled out a questionnaire regarding sleep, psychiatric symptoms and attitudes towards their own aging.Results: A logistic regression analysis found psychiatric symptoms and problems keeping awake to be independently related to a negative attitude towards one's own aging. Neither sleep, sex nor age demonstrated any relationship with the negative attitudes of elderly individuals.Conclusion: Excessive daytime sleepiness is related to poor morale regardless of both the quality and quantity of sleep and psychiatric symptoms.

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The importance of alcohol in elderly's hospital admissions for fall injuries: a population case-control study

Nordic Studies on Alcohol and Drugs ◽

10.1177/14550725211015836 ◽

2021 ◽

pp. 145507252110158

Author(s):

Elin K. Bye ◽

Stig Tore Bogstrand ◽

Ingeborg Rossow

Keyword(s):

Risk Factor ◽

Elderly People ◽

Alcohol Intoxication ◽

The Elderly ◽

Case Control ◽

Drinking Pattern ◽

Elderly Persons ◽

Fall Injuries ◽

Patient Reported ◽

Risk Of Fall

Background: Fall injuries account for a substantial part of the health burden among elderly persons, and they often affect life quality severely and impose large societal costs. Alcohol intoxication is a well-known risk factor for accidental injuries, but less is known about this association among elderly people. In this study, our aim was to assess whether risk of fall injuries among the elderly is elevated with an intoxication-oriented drinking pattern. Method: We applied a population case-control design and data from persons aged 60 years and over in Norway. Cases comprised patients with fall injuries admitted to a hospital emergency department ( n = 424), and controls were participants in general population surveys ( n = 1859). Drinking pattern was assessed from self-reports of drinking frequency and intoxication frequency. Age and gender-adjusted association between fall injury and drinking pattern was estimated in logistic regression models. Fall injuries were considered alcohol-related if blood alcohol concentration exceeded 0.01% and/or the patient reported alcohol intake within six hours prior to injury. Results: The risk of fall injuries was highly elevated among those reporting drinking to intoxication monthly or more often ( OR = 10.2, 95% CI 5.5–19.0). Among cases, the vast majority of those with alcohol-related fall injuries (64 of 68) reported drinking to intoxication. Conclusions: A drinking pattern comprising alcohol intoxication elevated the risk of fall injuries among elderly people. As alcohol use is a modifiable risk factor, the findings suggest a potential to curb the number of fall injuries and their consequences by employing effective strategies to prevent intoxication drinking among the elderly.

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Physical Illness and Suicide Risk in Rural Residents of Contemporary China

Crisis ◽

10.1027/0227-5910/a000271 ◽

2014 ◽

Vol 35 (5) ◽

pp. 330-337 ◽

Cited By ~ 14

Author(s):

Cun-Xian Jia ◽

Lin-Lin Wang ◽

Ai-Qiang Xu ◽

Ai-Ying Dai ◽

Ping Qin

Keyword(s):

Risk Factor ◽

Family Income ◽

Rural China ◽

Significant Risk ◽

Significant Risk Factor ◽

Health Condition ◽

Physical Illness ◽

Rural Residents ◽

Increased Risk ◽

Study Population

Background: Physical illness is linked with an increased risk of suicide; however, evidence from China is limited. Aims: To assess the influence of physical illness on risk of suicide among rural residents of China, and to examine the differences in the characteristics of people completing suicide with physical illness from those without physical illness. Method: In all, 200 suicide cases and 200 control subjects, 1:1 pair-matched on sex and age, were included from 25 townships of three randomly selected counties in Shandong Province, China. One informant for each suicide or control subject was interviewed to collect data on the physical health condition and psychological and sociodemographic status. Results: The prevalence of physical illness in suicide cases (63.0%) was significantly higher than that in paired controls (41.0%; χ2 = 19.39, p < .001). Compared with suicide cases without physical illness, people who were physically ill and completed suicide were generally older, less educated, had lower family income, and reported a mental disorder less often. Physical illness denoted a significant risk factor for suicide with an associated odds ratio of 3.23 (95% CI: 1.85–5.62) after adjusted for important covariates. The elevated risk of suicide increased progressively with the number of comorbid illnesses. Cancer, stroke, and a group of illnesses comprising dementia, hemiplegia, and encephalatrophy had a particularly strong effect among the commonly reported diagnoses in this study population. Conclusion: Physical illness is an important risk factor for suicide in rural residents of China. Efforts for suicide prevention are needed and should be integrated with national strategies of health care in rural China.

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