Vasiliadis Helen-Maria, Gournellis Rossetos, Efstathiou Vasiliki, Stefanis Nikos, Kosmidis Mary H, Yannakoulia Mary, Dardiotis Efthimios, Hadjigeorgiou Georgios, Sakka Paraskevi, Ntanasi Eva, Pachi Ioanna, Stefanis Leonidas, Scarmeas Nikolaos
Faculty of Medicine and Health Sciences, University of Sherbrooke, Charles-Le Moyne - Saguenay-Lac-Saint-Jean, Longueuil, Canada.
Second Department of Psychiatry, School of Medicine, National and Kapodistrian University of Athens, University General Hospital Attikon, Athens, Greece.
Aging Ment Health. 2022 May;26(5):1044-1052. doi: 10.1080/13607863.2021.1871882. Epub 2021 Jan 20.
The prevalence and associated factors related to psychotic symptoms in older adults are understudied. The objectives were to assess the prevalence, incidence and factors associated with psychotic symptoms in a representative Greek sample of community living older adults.
The sample includes = 1,904 residents of the cities of Larissa and Maroussi in Greece participating in the Hellenic Longitudinal Investigation of Aging and Diet study with available data at baseline and = 947 individuals at the 3-year follow-up. Past-month presence of delusions and hallucinations was assessed on the grounds of the 17 symptoms of the Columbia University Scale for Psychopathology in Alzheimer's Disease and 14 symptoms of the Neuropsychiatric Inventory Questionnaire. A comprehensive neuropsychological assessment for probable diagnosis of dementia and physical comorbidity was carried out by neurologists. Penalized logistic regression analyses were used to assess the socio-economic and clinical factors associated with psychotic symptoms.
Past-month prevalence of psychotic symptoms was 1.9% and 1.0% when excluding cases of dementia. The prevalence of any delusion and hallucination was 0.8% and 0.3% when excluding dementia. The incidence of psychotic symptoms without dementia was 1.3%. Recent widows and farmers/breeders/craftsmen, versus public servants/teachers/executives, had both six times the odds of experiencing psychotic symptoms without dementia. Hearing impairment and the number of health conditions also increased the odds while increased age was protective.
Psychotic symptoms unrelated to dementia constitute a considerable mental health problem in old age. Paranoid delusions were the most prevalent. Socio-economic and health status factors are significant predictors of psychotic symptoms.
老年人中精神病性症状的患病率及相关因素研究不足。目的是评估希腊具有代表性的社区居住老年人样本中精神病性症状的患病率、发病率及相关因素。
样本包括希腊拉里萨和马鲁西两市的1904名居民，他们参与了希腊老龄化与饮食纵向调查研究，基线时有可用数据，3年随访时有947人。根据阿尔茨海默病哥伦比亚大学精神病理学量表的17项症状和神经精神科问卷的14项症状评估过去一个月是否存在妄想和幻觉。神经科医生对可能的痴呆症诊断和身体合并症进行了全面的神经心理学评估。采用惩罚逻辑回归分析来评估与精神病性症状相关的社会经济和临床因素。
排除痴呆症病例后，过去一个月精神病性症状的患病率为1.9%和1.0%。排除痴呆症后，任何妄想和幻觉的患病率分别为0.8%和0.3%。无痴呆症的精神病性症状发病率为1.3%。与公务员/教师/高管相比，近期丧偶者和农民/饲养员/工匠出现无痴呆症的精神病性症状的几率均为其6倍。听力障碍和健康状况数量也增加了患病几率，而年龄增长具有保护作用。
与痴呆症无关的精神病性症状是老年期相当严重的心理健康问题。偏执妄想最为常见。社会经济和健康状况因素是精神病性症状的重要预测因素。
