Mortality among people with severe mental disorders who reach old age: a longitudinal study of a community-representative sample of 37,892 men

Almeida, Osvaldo P., Hankey, Graeme J., Yeap, Bu B., Golledge, Jonathan, Norman, Paul E., and Flicker, Leon (2014) Mortality among people with severe mental disorders who reach old age: a longitudinal study of a community-representative sample of 37,892 men. PLoS ONE, 9 (10). e11188. pp. 1-11.

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Abstract

Background: Severe mental illnesses are leading causes of disability worldwide. Their prevalence declines with age, possibly due to premature death. It is unclear, however, if people with severe mental disorders who reach older age still have lower life expectancy compared with their peers and if their causes of death differ.

Methods and findings: Cohort study of a community-representative sample of 37892 Australian men aged 65-85 years in 1996-1998. Follow up was censored on the 31st December 2010. Lifetime prevalence of schizophrenia spectrum, bipolar, depressive and alcohol-induced disorder was established through record linkage. A subsample of 12136 consented to a face-to-face assessment of sociodemographic, lifestyle and clinical variables. Information about causes of death was retrieved from the Australian Death Registry. The prevalence of schizophrenia spectrum, bipolar, depressive and alcohol-induced disorders was 1.2%, 0.3%, 2.5% and 1.8%. The mortality hazard for men with a severe mental disorder was 2.3 and their life expectancy was reduced by 3 years. Mortality rates increased with age, but the gap between men with and without severe mental disorders was not attenuated by age. Cardiovascular diseases and cancer were the most frequent causes of death. The excess mortality associated with severe mental disorders could not be explained by measured sociodemographic, lifestyle or clinical variables.

Conclusions: The excess mortality associated with severe mental disorders persists in later life, and the causes of death of younger and older people with severe mental disorders are similar. Hazardous lifestyle choices, suboptimal access to health care, poor compliance with treatments, and greater severity of medical comorbidities may all contribute to this increased mortality. Unlike young adults, most older people will visit their primary care physician at least once a year, offering health professionals an opportunity to intervene in order to minimise the harms associated with severe mental disorders.

Item ID: 37639
Item Type: Article (Research - C1)
ISSN: 1932-6203
Additional Information:

© 2014 Almeida et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Funders: National Health and Medical Research Council of Australia (NHMRC)
Projects and Grants: NHMRC project grant 279408, NHMRC project grant 379600, NHMRC project grant 403963, NHMRC project grant 513823, NHMRC project grant 634492
Date Deposited: 04 Mar 2015 01:43
FoR Codes: 11 MEDICAL AND HEALTH SCIENCES > 1102 Cardiovascular Medicine and Haematology > 110201 Cardiology (incl Cardiovascular Diseases) @ 100%
SEO Codes: 92 HEALTH > 9201 Clinical Health (Organs, Diseases and Abnormal Conditions) > 920103 Cardiovascular System and Diseases @ 100%
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