Madhusoodanan Subramoniam, Ibrahim Fayaz A, Malik Arsalan
Department of Psychiatry, St. John's Episcopal Hospital, Far Rockaway, NY 11691, USA.
Ann Clin Psychiatry. 2010 Nov;22(4):249-61.
It is estimated that the number of older adults with mental illness will increase from 4 million in 1970 to 15 million by 2030. The cost of untreated mental illness in the United States is estimated to be >$100 billion annually and nearly half of that cost can be attributed to persons age ≥60. In this paper we present a comprehensive review of empiric data available on primary prevention for the most common psychiatric illnesses in this patient population.
We did an English language literature review of published studies and selected only those with the strongest emphasis on primary prevention for the most common psychiatric illnesses in older adults.
Modifiable and nonmodifiable risk factors and several primary prevention strategies have been described, several of them with positive outcomes mainly for depressive disorders and suicide. In conditions such as bipolar disorder, dementias, and geriatric schizophrenia, there is either a paucity of studies or no robust primary prevention strategies identified.
Modification of risk factors, a healthy lifestyle that includes a healthy diet, exercise, socialization, and education are important aspects of primary prevention in elderly patients. Genetic engineering and vaccine therapies may open new and exciting opportunities for prevention of many psychiatric illnesses in the near future.
据估计，患有精神疾病的老年人数量将从1970年的400万增加到2030年的1500万。在美国，未经治疗的精神疾病每年的花费估计超过1000亿美元，其中近一半的费用可归因于60岁及以上的人群。在本文中，我们对该患者群体中最常见精神疾病的一级预防现有实证数据进行了全面综述。
我们对已发表的研究进行了英文文献综述，仅选择那些最着重于老年人最常见精神疾病一级预防的研究。
已描述了可改变和不可改变的风险因素以及几种一级预防策略，其中一些主要对抑郁症和自杀有积极效果。在双相情感障碍、痴呆症和老年精神分裂症等疾病方面，要么研究较少，要么未确定有力的一级预防策略。
改变风险因素、包括健康饮食、运动、社交和教育在内的健康生活方式是老年患者一级预防的重要方面。基因工程和疫苗疗法可能在不久的将来为预防许多精神疾病带来新的、令人兴奋的机会。
