Thursday, 21 August 2003
This presentation is part of : Thursday Poster Sessions

PD-067 Clinical Characteristics and Hospital Based Resource Use Among Older Adults with Bipolar Disorder, Schizophrenia and Schizoaffective Disorder, Depression, and Dementia

Martha Sajatovic1, Susan Hatters Friedman1, Josephine Sabharwal1, and C. Raymond Bingham2. (1) Psychiatry, Case Western Reserve University School of Medicine, Cleveland, OH, USA, (2) Psychiatry, University of Michigan, Ann Arbor, MI, USA

Objective: Although many older adults with serious psychiatric illness share common concerns such as medical comorbidity, personal loss, greater propensity to medication adverse effects and greater dependence on others for basic needs such as transportation, individualized treatment needs must also be differentiated based upon underlying psychiatric disorder. The objective of this study was to clinical characteristics and hospital based resource use among older adults with bipolar disorder, schizophrenia/schizoaffective disorder, depression and dementia.

Design: This was a retrospective, electronic record review of consecutive hospital discharges over a 5 month period.

Materials and Methods: The records of older adults, age 50 and older, discharged from an inpatient geropsychiatric unit were evaluated on a variety of clinical and health resource use variables.

Results: There were 137 patients, mean age 73.5 years, with either schizophrenia/schizoaffective disorder (N=35), bipolar disorder (N=21), major depression (N=32) or dementia (N=49). Women were significantly overrepresented among individuals with schizophrenia/schizoaffective disorder compared to older adults with bipolar disorder, depression, and dementia (p=.034). Among older adults with bipolar disorder and in contrast to what might be expected in younger populations, anticonvulsant medications were predominantly utilized as mood stabilizers with only rare use of lithium. While there were a greater proportion of older adults with bipolar disorder who abused substances (19%) compared to older adults from other diagnostic groups, this difference was not statistically significant. Substance abuse was relatively uncommon in the group as a whole (6.6%). Individuals with schizophrenia/ schizoaffective disorder were the youngest group of hospitalized geriatric patients, while individuals with dementia were the oldest group (p<.001).

Conclusion: There are significant differences in clinical characteristics and resource use among hospitalized older adults with serious mental illnesses. There is a gender disparity among older adults with schizophrenia, which has substantial implications in treatment planning. It is possible that fewer individuals with serious chronic psychiatric disorders survive to their eighth and ninth decades due to increased morbidity and mortality associated with their psychiatric illness. Additional studies are needed on outcomes of serious chronic psychiatric illness in late life to help us plan for and provide optimal care environments for these older adult populations.

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