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Investigation of risk of dementia diagnosis and death in patients in older people's secondary care mental health services
OBJECTIVES: Previous studies have shown increased rates of death and dementia in older people in specific serious mental illnesses (SMI) such as bipolar disorder or depression. We examined the rates of death and dementia in older people referred into a secondary care psychiatric service across a ran...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
John Wiley and Sons Inc.
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7984055/ https://www.ncbi.nlm.nih.gov/pubmed/33113255 http://dx.doi.org/10.1002/gps.5455 |
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author | Kershenbaum, Anne Cardinal, Rudolf N. Chen, Shanquan Underwood, Benjamin R. Seyedsalehi, Aida Lewis, Jonathan Rubinsztein, Judy Sasha |
author_facet | Kershenbaum, Anne Cardinal, Rudolf N. Chen, Shanquan Underwood, Benjamin R. Seyedsalehi, Aida Lewis, Jonathan Rubinsztein, Judy Sasha |
author_sort | Kershenbaum, Anne |
collection | PubMed |
description | OBJECTIVES: Previous studies have shown increased rates of death and dementia in older people in specific serious mental illnesses (SMI) such as bipolar disorder or depression. We examined the rates of death and dementia in older people referred into a secondary care psychiatric service across a range of SMIs. METHODS: We used an anonymised dataset across 6 consecutive years with 28,340 patients aged 65 years and older from a single secondary care psychiatric trust in the United Kingdom. We identified deaths and incident dementia in patients with bipolar disorder/mania, schizophrenia, recurrent depression and anxiety disorders. We compared mortality and dementia rates between these diagnostic groups and in different treatment settings. We also examined mortality rates and dementia rates compared with general population rates. RESULTS: Patients with schizophrenia showed the highest hazard rate for death compared to other groups with SMIs (hazard ratio, 1.58; 95% confidence interval (CI), 1.18–2.1, with anxiety group the reference). Survival was reduced in patients referred to liaison psychiatry services. There were no significant differences between the SMI groups in terms of rates of dementia. However, risks of death and dementia were significantly increased compared to the general population (standardized mortality rates with 95% CI, 2.6(2.0–3.3), 3.5(2.6–4.5), 2.5(2.0–3.0) and 1.8 (1.4–2.2) and standardized dementia incidence rates with 95% CI, 2.7(1.5–4.1), 2.9(1.5–4.7), 3.8(2.6–5.2) and 4.3 (3.0–5.7) for bipolar disorder/mania, schizophrenia, recurrent depression and anxiety disorders respectively. CONCLUSIONS: Older adults referred into an old age psychiatry service show higher rates of dementia and death than those reported for the general population. |
format | Online Article Text |
id | pubmed-7984055 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | John Wiley and Sons Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-79840552021-03-24 Investigation of risk of dementia diagnosis and death in patients in older people's secondary care mental health services Kershenbaum, Anne Cardinal, Rudolf N. Chen, Shanquan Underwood, Benjamin R. Seyedsalehi, Aida Lewis, Jonathan Rubinsztein, Judy Sasha Int J Geriatr Psychiatry Research Articles OBJECTIVES: Previous studies have shown increased rates of death and dementia in older people in specific serious mental illnesses (SMI) such as bipolar disorder or depression. We examined the rates of death and dementia in older people referred into a secondary care psychiatric service across a range of SMIs. METHODS: We used an anonymised dataset across 6 consecutive years with 28,340 patients aged 65 years and older from a single secondary care psychiatric trust in the United Kingdom. We identified deaths and incident dementia in patients with bipolar disorder/mania, schizophrenia, recurrent depression and anxiety disorders. We compared mortality and dementia rates between these diagnostic groups and in different treatment settings. We also examined mortality rates and dementia rates compared with general population rates. RESULTS: Patients with schizophrenia showed the highest hazard rate for death compared to other groups with SMIs (hazard ratio, 1.58; 95% confidence interval (CI), 1.18–2.1, with anxiety group the reference). Survival was reduced in patients referred to liaison psychiatry services. There were no significant differences between the SMI groups in terms of rates of dementia. However, risks of death and dementia were significantly increased compared to the general population (standardized mortality rates with 95% CI, 2.6(2.0–3.3), 3.5(2.6–4.5), 2.5(2.0–3.0) and 1.8 (1.4–2.2) and standardized dementia incidence rates with 95% CI, 2.7(1.5–4.1), 2.9(1.5–4.7), 3.8(2.6–5.2) and 4.3 (3.0–5.7) for bipolar disorder/mania, schizophrenia, recurrent depression and anxiety disorders respectively. CONCLUSIONS: Older adults referred into an old age psychiatry service show higher rates of dementia and death than those reported for the general population. John Wiley and Sons Inc. 2020-11-04 2021-04 /pmc/articles/PMC7984055/ /pubmed/33113255 http://dx.doi.org/10.1002/gps.5455 Text en © 2020 The Authors. International Journal of Geriatric Psychiatry published by John Wiley & Sons Ltd. This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Research Articles Kershenbaum, Anne Cardinal, Rudolf N. Chen, Shanquan Underwood, Benjamin R. Seyedsalehi, Aida Lewis, Jonathan Rubinsztein, Judy Sasha Investigation of risk of dementia diagnosis and death in patients in older people's secondary care mental health services |
title | Investigation of risk of dementia diagnosis and death in patients in older people's secondary care mental health services |
title_full | Investigation of risk of dementia diagnosis and death in patients in older people's secondary care mental health services |
title_fullStr | Investigation of risk of dementia diagnosis and death in patients in older people's secondary care mental health services |
title_full_unstemmed | Investigation of risk of dementia diagnosis and death in patients in older people's secondary care mental health services |
title_short | Investigation of risk of dementia diagnosis and death in patients in older people's secondary care mental health services |
title_sort | investigation of risk of dementia diagnosis and death in patients in older people's secondary care mental health services |
topic | Research Articles |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7984055/ https://www.ncbi.nlm.nih.gov/pubmed/33113255 http://dx.doi.org/10.1002/gps.5455 |
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