Department of Geriatric Mental Health, King George Medical University, Lucknow, Uttar Pradesh, India.
Department of Neurology, King George Medical University, Lucknow, Uttar Pradesh, India.
Indian J Psychiatry. 2014 Apr;56(2):154-60. doi: 10.4103/0019-5545.130496.
Paucity of systematic studies in elderly mental health in an aging population is an urgent need, which is required to address services and planning issues for health.
The present study aims to investigate the distribution of physical, neuropsychiatric, and cognitive disorders of a community sample of elderlies with certain socioeconomic data.
A door-to-door household survey was conducted to identify houses with elderlies (≥55 years) in two urban localities of Lucknow. Mini mental state examination (MMSE), Survey Psychiatric Assessment Schedule (SPAS)/Mood Disorder Questionnaire (MDQ) and physical and neurological examination were used for screening all consenting elderlies. MMSE positive participants were assessed on Cambridge Mental Disorders of the Elderly Examination-Revised for diagnosis of cognitive disorders; SPAS/MDQ positives were assessed on Schedule for Clinical Assessment in Neuropsychiatry based clinical interview for diagnosis of neuropsychiatric disorders other than cognitive disorders (using ICD-10 criteria). Routine and indicated laboratory/radiological investigations on all and on MMSE/SPAS (organic section) positive/physically ill participants respectively were done to confirm organic and/or physical illness. Only percentages were calculated to find the distribution of morbidity.
The sample had proportionate age structure as that of the surveyed population and had balanced gender representation in each age deciles. Prevalence of neuropsychiatric disorders (with/without comorbidities) was 11.8% in the elderlies (60 years and above) highest being in the 60-69 years age group. Being women and of lower socioeconomic status was more commonly associated with a neuropsychiatric diagnosis. 7.6% of the elderlies had cognitive impairment. Overall findings suggest a prevalence rate of 17.34% of total psychiatric morbidity among elderlies. A significant number had comorbid physical illness diagnoses.
More than half the elderlies had some diagnosable physical or mental ailment. The study familiarizes us to the significant amount of physical and psychiatric comorbidity in the particular age group. About one-fifth was found to suffer from psychiatric morbidity, which any health services for the elderly should be oriented towards.
在人口老龄化的背景下，老年人心理健康的系统研究相对较少，这是迫切需要解决的服务和规划问题。
本研究旨在调查具有特定社会经济数据的社区老年人样本中身体、神经精神和认知障碍的分布情况。
通过挨家挨户的家庭调查，在勒克瑙的两个城区确定了有老年人（≥55 岁）的房屋。使用简易精神状态检查（MMSE）、调查性精神评估量表（SPAS）/情绪障碍问卷（MDQ）和身体及神经系统检查对所有同意参与的老年人进行筛查。MMSE 阳性的参与者接受剑桥老年人精神障碍检查修订版（CAMDEX-R）评估，以诊断认知障碍；SPAS/MDQ 阳性的参与者接受基于临床访谈的精神科临床评估量表（SCAN）评估，以诊断认知障碍以外的神经精神障碍（使用 ICD-10 标准）。对所有参与者进行常规和必要的实验室/放射学检查，以及对 MMSE/SPAS（有机部分）阳性/身体不适的参与者进行检查，以确定是否存在器质性和/或躯体疾病。仅计算百分比以确定发病率的分布。
该样本的年龄结构与调查人口的年龄结构相当，且在每个年龄十分位数中性别比例平衡。老年人（60 岁及以上）的神经精神障碍（伴/不伴共病）患病率为 11.8%，其中 60-69 岁年龄组患病率最高。女性和社会经济地位较低与神经精神诊断更为相关。7.6%的老年人存在认知障碍。总体研究结果表明，老年人总精神发病率为 17.34%。相当一部分老年人存在多种躯体疾病诊断。
超过一半的老年人存在某种可诊断的身体或精神疾病。该研究使我们熟悉了特定年龄组中大量的躯体和精神共病。约五分之一的人患有精神疾病，这应该是老年人健康服务的重点。
