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Physical health challenges faced by elders with severe mental illness: population-based retrospective cohort study.

Authors :
Chang CK
Hayes RD
Broadbent M
Shetty H
Su YP
Meesters PD
Stewart R
Source :
BJPsych open [BJPsych Open] 2024 Oct 15; Vol. 10 (6), pp. e178. Date of Electronic Publication: 2024 Oct 15.
Publication Year :
2024

Abstract

Background: Severe mental illness (SMI), which includes schizophrenia, schizoaffective disorder and bipolar disorder, has profound health impacts, even in the elderly.<br />Aims: To evaluate relative risk of hospital admission and length of hospital stay for physical illness in elders with SMI.<br />Method: To construct a population-based retrospective cohort observed from April 2007 to March 2016, data from a case registry with full but de-identified electronic health records were retrieved for patients of the South London and Maudsley NHS Foundation Trust, the single secondary mental healthcare service provider in south-east London. We compared participants with SMI aged >60 years old with the general population of the same age and residing in the same areas through data linkage by age-, sex- and fiscal-year-standardised admission ratios (SARs) for primary diagnoses at hospital discharge. Furthermore, we compared the duration of hospital stay with an age-, sex- and cause-of-admission-matched random group by linear regression for major causes of admission.<br />Results: In total, records for 4175 older people with SMI were obtained, relating to 10 342 admission episodes, showing an overall SAR for all physical illnesses of 5.15 (95% CI: 5.05, 5.25). Among the top causes of admission, SARs ranged from 3.87 for circulatory system disorders (ICD-10 codes: I00-I99) to 6.99 for genitourinary system or urinary conditions (N00-N39). Specifically, the diagnostic group of 'symptoms, signs and findings, not elsewhere classified' (R00-R99) had an elevated SAR of 6.56 (95% CI: 6.22, 6.90). Elders with SMI also had significantly longer hospital stays than their counterparts in the general population, especially for digestive system illnesses (K00-K93), after adjusting for confounding.<br />Conclusions: Poorer overall physical health and specific patterns were identified in elders with SMI.

Details

Language :
English
ISSN :
2056-4724
Volume :
10
Issue :
6
Database :
MEDLINE
Journal :
BJPsych open
Publication Type :
Academic Journal
Accession number :
39402937
Full Text :
https://doi.org/10.1192/bjo.2024.765