Department of Veterans Affairs Palo Alto Health Care System, Center for Health Care Evaluation, 795 Willow Rd., Menlo Park, CA 94025, USA.
Psychiatr Serv. 2010 Apr;61(4):356-63. doi: 10.1176/ps.2010.61.4.356.
This study identified recent changes in the prevalence of psychiatric disorders among Department of Veterans Affairs (VA) nursing home residents.
Psychiatric diagnoses in administrative databases were summarized for nursing home residents in 1998, 2002, and 2006. Census prevalence rates were compared with findings from earlier VA nursing home surveys. Prevalence rates were compared for age groups and birth cohorts of VA nursing home admissions in 1998 (N=27,734) and 2006 (N=32,543).
Among residents in the census samples, prevalence rates for dementia and schizophrenia fluctuated moderately from 1990 to 2006, depression prevalence increased sharply, alcohol use disorder prevalence declined, and drug use disorder prevalence increased. Among 1998 and 2006 admissions, dementia prevalence increased for most birth cohorts but declined for most age groups (35% to 32% overall). Depression prevalence increased for all age groups and birth cohorts (27% to 37% overall), as did posttraumatic stress disorder prevalence (5% to 12% overall). Serious mental illness prevalence increased among the oldest residents and birth cohorts (19% to 22% overall). Alcohol use disorder prevalence declined for all birth cohorts and most age groups (18% to 16% overall), but drug use disorder prevalence increased substantially for younger age groups (6% to 9% overall).
Examining differences in prevalence between birth cohorts and age groups can clarify trends in nursing home resident characteristics and improve projections of their future needs.
本研究旨在确定退伍军人事务部（VA）疗养院居民中精神障碍的患病率近期变化。
对 1998 年、2002 年和 2006 年疗养院居民的行政数据库中的精神科诊断进行了总结。与之前 VA 疗养院调查的结果进行了普查患病率的比较。比较了 1998 年（N=27734）和 2006 年（N=32543）VA 疗养院入院的年龄组和出生队列的患病率。
在普查样本中，1990 年至 2006 年间，痴呆症和精神分裂症的患病率波动较大，抑郁症患病率急剧上升，酒精使用障碍患病率下降，药物使用障碍患病率上升。在 1998 年和 2006 年入院的患者中，大多数出生队列的痴呆症患病率增加，但大多数年龄组的患病率下降（总体下降 35%至 32%）。所有年龄组和出生队列的抑郁症患病率都有所增加（总体增加 27%至 37%），创伤后应激障碍的患病率也有所增加（总体增加 5%至 12%）。最年长的居民和出生队列的严重精神疾病患病率增加（总体增加 19%至 22%）。所有出生队列和大多数年龄组的酒精使用障碍患病率都有所下降（总体下降 18%至 16%），但年轻年龄组的药物使用障碍患病率显著增加（总体增加 6%至 9%）。
比较出生队列和年龄组之间的患病率差异可以阐明疗养院居民特征的趋势，并改善对其未来需求的预测。
