Department of Psychiatry, Queen's University, Kingston, Ontario, Canada.
Can J Psychiatry. 2012 Sep;57(9):554-63. doi: 10.1177/070674371205700906.
As the numbers of older adults in Canada increases, there will be a growing need for mental health services for this population. Acute psychiatric units (APUs) provide inpatient psychiatric services for the management of serious mental illness. Understanding the characteristics of older adults in APUs is necessary to determine the range of inpatient services required for this population.
We conducted a population-based study of all adults discharged from APUs in Ontario in a 2-year period, 2008-2010, using administrative databases. We compared the characteristics of older adults (aged 66 years and older) in APUs to those of younger adults (aged 18 to 65 years), including sociodemographics, psychiatric and medical diagnoses, and measures of cognition and functioning.
There were a total of 79 352 discharges from APUs, with older adults accounting for 8.8% of all discharges. Depressive disorder was the most common diagnosis, both in older and in younger populations (32.1% and 29.9%, respectively), while dementia accounted for 19.5% of discharges for older adults. Older adults, compared with younger adults, were more likely to have 2 or more chronic medical conditions (83.8% and 20.5%, respectively), significant cognitive impairment (47.0% and 14.5%, respectively), and moderate-to-severe functional impairment (21.8% and 3.3%, respectively).
Older adults in APUs are a complex group, with mental health and medical care needs that differ from younger adults. APUs must be able to provide adequate psychiatric, medical, and interprofessional services to achieve optimal outcomes. Future studies are required to understand the quality of care and outcomes for older adults in APUs.
随着加拿大老年人口的增加，对该人群的心理健康服务的需求也将不断增长。急性精神病病房（APU）为严重精神疾病的管理提供住院精神病服务。了解 APU 中老年人的特点对于确定该人群所需的住院服务范围是必要的。
我们使用行政数据库对 2008 年至 2010 年期间安大略省所有从 APU 出院的成年人进行了一项基于人群的研究。我们比较了 APU 中老年人（年龄 66 岁及以上）和年轻人（年龄 18 至 65 岁）的特征，包括社会人口统计学、精神和医学诊断以及认知和功能测量。
APU 共有 79352 人次出院，其中老年人占所有出院人数的 8.8%。抑郁障碍是最常见的诊断，在老年人和年轻人中均占 32.1%和 29.9%，而痴呆症占老年人出院人数的 19.5%。与年轻人相比，老年人更有可能患有 2 种或更多慢性疾病（分别为 83.8%和 20.5%）、认知功能显著受损（分别为 47.0%和 14.5%）以及中重度功能障碍（分别为 21.8%和 3.3%）。
APU 中的老年人是一个复杂的群体，他们的心理健康和医疗需求与年轻人不同。APU 必须能够提供足够的精神科、医疗和跨专业服务，以实现最佳结果。需要进一步研究以了解 APU 中老年人的护理质量和结果。
