Paquet Jacquelyn, Hibbard Katharine, Brett-MacLean Pamela
Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada.
Soc Psychiatry Psychiatr Epidemiol. 2025 Aug 6. doi: 10.1007/s00127-025-02969-2.
Older adults face unique risk factors for psychiatric illness, including comorbid medical concerns, loss, and loneliness. With the older adult population expected to triple in the next two decades, understanding patterns of prevalent psychiatric disorders, including anxiety, mood, and neurocognitive disorders is crucial for treatment and policy planning.
This longitudinal cohort design examined anxiety, mood, and neurocognitive disorders among older adults in Alberta, utilizing physician billing data from 2017 to 2022. Rates of presentations were compared before, during, and after the COVID-19 pandemic. The study assessed the influence of sex, geographic location (urban, rural) and healthcare setting (outpatient, emergency department, inpatient). Descriptive statistics, ANOVA, and regression analyses were performed to assess the impact of these factors on presentations.
Alberta's older adults had 1,365,423 presentations for mood, anxiety, and neurocognitive disorders from 2017 to 2022 with outpatient services comprising the majority, increased 28.18% during the pandemic. Anxiety was the most common (45.47%), followed by mood (34.76%) and neurocognitive disorders (18.77%). ANOVA showed no significant differences across pandemic phases for mood, anxiety or neurocognitive disorders. Regression analyses identified sex, geographic locations, and healthcare setting as significant predictors, with healthcare setting having the strongest effect. Interactions between sex, geographic location, and healthcare setting were significant for mood and anxiety disorders.
Psychiatric presentations varied by disorder, influenced by demographic and contextual factors. Healthcare setting was a significant predictor across all disorders. The lack of pandemic-related effects suggests a consistent impact across phases, highlighting the need for ongoing evaluation on the pandemic's long-term effects.
老年人面临着精神疾病的独特风险因素，包括合并的医疗问题、丧失和孤独感。预计在未来二十年中，老年人口将增至三倍，因此了解包括焦虑症、情绪障碍和神经认知障碍在内的常见精神疾病模式对于治疗和政策规划至关重要。
本纵向队列研究利用2017年至2022年艾伯塔省医生的计费数据，对该省老年人的焦虑症、情绪障碍和神经认知障碍进行了研究。比较了新冠疫情之前、期间和之后的就诊率。该研究评估了性别、地理位置（城市、农村）和医疗机构环境（门诊、急诊科、住院部）的影响。进行了描述性统计、方差分析和回归分析，以评估这些因素对就诊情况的影响。
2017年至2022年期间，艾伯塔省的老年人因情绪、焦虑和神经认知障碍就诊1365423次，其中门诊服务占大多数，疫情期间增加了28.18%。焦虑症最为常见（45.47%），其次是情绪障碍（34.76%）和神经认知障碍（18.77%）。方差分析显示，情绪、焦虑或神经认知障碍在疫情各阶段之间没有显著差异。回归分析确定性别、地理位置和医疗机构环境是显著的预测因素，其中医疗机构环境的影响最强。性别、地理位置和医疗机构环境之间的相互作用对情绪和焦虑障碍具有显著影响。
精神疾病的就诊情况因疾病而异，受人口统计学和环境因素影响。医疗机构环境是所有疾病的一个重要预测因素。缺乏与疫情相关的影响表明各阶段的影响是一致的，这突出了对疫情长期影响进行持续评估的必要性。
