Aging Demographics and Psychiatric Diagnoses in the Elderly

: LA2-CO-161A

medicine concerned with prevention, diagnosis, and treatment of physical and

psychological disorders in the elderly and with the promotion of longevity

patient? What makes you ‘elderly’?
Age 65 and older: elderly, ‘old’
Age

85 and older: ‘very old’ or ‘old, old’
Age 100 and older: ‘oldest old’


“Baby Boomers” – those born between 1946 - 1964, 78 million US Americans alive today and will be turning 60 years of age in 2006  2024.……“Graying of America”

years; 1991 = 79 years for women/72 years for men*
In

the year 2000 = 12.4% of the U.S. population - 35 million Americans - were 65 years or older*
By 2030 = percentage increased to 20% -1 in 5 people will be older than 65; 2025 in Florida – 1 in 4 people
People age 85 and older: are the fastest growing segment of our population – from 4 M today to 20 M by 2050;* constitute 10% of those 65 years and older; there are 39 men for every 100 women 85 years old or older

.

largest amount of Medicare resources; 5% of the Medicare population

consumes 50% of the Medicare dollars – many are the ‘frail elderly’
On average, by age 75, older adults have between two and three chronic medical conditions; some as many as ten to twelve medical conditions and as many medications

age of 65 has a mental illness
As the population ages,

the number of people with mental illness will double to 15 million by 2030
Number of people over age 65 years with mental illness will equal the number of people with mental illness in ALL other age groups
Older adults are less likely to seek mental health: only 4% of non-institutionalized US population seek mental health treatment
Older adults are more likely to be identified, diagnosed and receive treatment from their primary care physician.

Mental Retardation
Axis III: General Medical

Conditions
Axis IV: Stressors (primary and/or secondary GMC, support group, education, housing, access to health care, occupational, financial, legal, social, recent loss and other psychosocial and environmental problems)
Axis V: GAF (Global Assessment of Functioning - scale 0-100)

disorders, anxiety disorders and alcohol use disorders

Psychiatric disorders other than

depression are found in lower prevalence among the elderly than at any other stages of the life cycle

Suicide risk in the elderly

Caucasians account for more than 90% of all suicides
Age clusters:

age 15-19, 20-24 and over age 60
Marital status: widowed, divorced and single individuals at greater risk than married individuals (more pronounced in men)
Living alone; no children under age 18 living in household
Alcohol/Substance Abuse history
History of mental illness; previous suicide attempt
Firearm(s) in the home
30% have seen a physician within 30 days; 60% have seen a physician within 6 months

disorders
Depression
Generalized
anxiety
disorder
Specific (simple) phobia
Obsessive compulsive disorder
Social anxiety disorder
Panic disorder
Post-
traumatic

stress
disorder

Interrelationships Among Depression and Anxiety Disorders

18-34 – 14%
Age 35-49 – 15%
Age 50-64 – 20%
Age 65-79

– 25%

a lifelong disease with a relapsing, remitting course, has a

genetic component along with environmental and interpersonal factors………….

14 Million Projected Within a Generation
Year

victims are physically frail; 50% are unable to care for

themselves; many are confused or disoriented – some or most of the time
Majority occurs in home setting
Majority of perpetrators are family members usually a spouse or adult child