Skip to main content Accessibility help

We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.

Close cookie message
×
Hostname: page-component-848d4c4894-pftt2 Total loading time: 0 Render date: 2024-04-30T21:17:05.429Z Has data issue: false hasContentIssue false

Chapter 1 - Epidemiology and Mental Health in Old Age

from Section 1 - Epidemiology and Types of Disorders

Published online by Cambridge University Press:  12 September 2020

By
Philippa Lilford  and
Julian C Hughes
Edited by
Julian C. Hughes  and
Philippa Lilford
Julian C. Hughes
Affiliation:
University of Bristol
Philippa Lilford
Affiliation:
Severn Deanery, University of Bristol
Get access

Summary

Epidemiology is the study of disease and its determinants in populations. Epidemiological studies investigate what the patterns of diseases are and why they develop in particular populations. Epidemiology is important in improving our understanding of what causes disease. Similarly, understanding epidemiology and how to interpret observational data is crucial to avoid inaccurate causal inferences. Unfortunately, critically evaluating all of the data on mental health problems in old age was outside the scope of this chapter, but we try to highlight some important limitations and gaps in the literature. There are exciting developments in epidemiology that will guide our knowledge about the determinants of psychiatric disease. For example, genome-wide association studies (GWAS) are increasing our understanding of genetic associations with psychiatric diseases.

Type
Chapter
Information
Clinical Topics in Old Age Psychiatry , pp. 5 - 23
Publisher: Cambridge University Press
Print publication year: 2020

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Woodward, M. Epidemiology. Chapman and Hall/CRC, 2013. DOI:10.1201/b16343CrossRefGoogle Scholar
Livingston, G, Sommerlad, A, Orgeta, V et al. Dementia prevention, intervention, and care. Lancet. 2017;390(10113):2673–2734. DOI:10.1016/S0140-6736(17)31363-6Google Scholar
Jorm, AF, Korten, AE, Henderson, AS. The prevalence of dementia: a quantitative integration of the literature. Acta Psychiatr Scand. 1987;76(5):465–479. DOI:10.1111/j.1600-0447.1987.tb02906.xCrossRefGoogle ScholarPubMed
Minett, T, Stephan, B, Brayne, C. Epidemiology of old age psychiatry: an overview of concepts and main studies. In Oxford Textbook of Old Age Psychiatry (2nd edn) (eds Dening, T, Thomas, A): 57–85. Oxford University Press, 2013Google Scholar
Castle, DJ, Murray, RM. The Epidemiology of Late-Onset Schizophrenia. Vol 19; 1993. https://academic.oup.com/schizophreniabulletin/article-abstract/19/4/691/1888798. Accessed 13 February 2019.Google Scholar
Jorm, AF. History of depression as a risk factor for dementia: an updated review. Aust New Zeal J Psychiatry. 2001;35(6):776–781. DOI:10.1046/j.1440-1614.2001.00967.xGoogle Scholar
Singh-Manoux, A, Dugravot, A, Fournier, A et al. Trajectories of depressive symptoms before diagnosis of dementia. JAMA Psychiatry. 2017;74(7):712. DOI:10.1001/jamapsychiatry.2017.0660Google Scholar
Sosa-Ortiz, AL, Acosta-Castillo, I, Prince, MJ. Epidemiology of dementias and Alzheimer’s disease. Arch Med Res. 2012;43(8):600–608. DOI:10.1016/j.arcmed.2012.11.003CrossRefGoogle ScholarPubMed
Yu-Tzu Wu, A, Beiser, AS, B Breteler, MM et al. The changing prevalence and incidence of dementia over time-current evidence. Nat Rev Neurol. 2017;13(6):327. DOI:10.1038/nrneurol.2017.63Google Scholar
Matthews, FE, Arthur, A, Barnes, LE et al. A two-decade comparison of prevalence of dementia in individuals aged 65 years and older from three geographical areas of England: results of the Cognitive Function and Ageing Study I and II. Lancet (London, England). 2013;382(9902):1405–1412. DOI:10.1016/S0140-6736(13)61570-6Google Scholar
Wharton, SB, Brayne, C, Savva, GM et al. Epidemiological neuropathology: the MRC cognitive function and aging study experience. J Alzheimer’s Dis. 2011;25(2):359–372. DOI:10.3233/JAD-2011-091402Google Scholar
Snowdon, DA, Nun Study. Healthy aging and dementia: findings from the Nun Study. Ann Intern Med. 2003;139(5 Pt 2):450–454. DOI:10.7326/0003-4819-139-5_part_2-200309021-00014CrossRefGoogle ScholarPubMed
Bennett, HQ, Norton, S, Bunn, F et al. The impact of dementia on service use by individuals with a comorbid health condition: a comparison of two cross-sectional analyses conducted approximately 10 years apart. BMC Med. 2018;16(1):114. DOI:10.1186/s12916-018-1105-8Google Scholar
He, FJ, Pombo-Rodrigues, S, MacGregor, GA. Salt reduction in England from 2003 to 2011: its relationship to blood pressure, stroke and ischaemic heart disease mortality. BMJ Open. 2014;4(4):e004549. DOI:10.1136/bmjopen-2013-004549Google Scholar
Marioni, RE, Valenzuela, MJ, van den Hout, A, Brayne, C, Matthews, FE, MRC cognitive function and ageing study. Active cognitive lifestyle is associated with positive cognitive health transitions and compression of morbidity from age sixty-five. Fielding R, ed. PLoS One. 2012;7(12):e50940. DOI:10.1371/journal.pone.0050940Google Scholar
Prince, M, Bryce, R, Albanese, E et al. The global prevalence of dementia: a systematic review and metaanalysis. Alzheimer’s Dement. 2013;9(1):63–75.e2. DOI:10.1016/j.jalz.2012.11.007Google Scholar
Prince, M, Ferri, CP, Acosta, D et al. The protocols for the 10/66 dementia research group population-based research programme. BMC Public Health. 2007;7(1):165. DOI:10.1186/1471-2458-7-165Google Scholar
Rodriguez, JJL, Ferri, CP, Acosta, D et al. Prevalence of dementia in Latin America, India, and China: a population-based cross-sectional survey. Lancet. 2008;372(9637):464–474. DOI:10.1016/S0140-6736(08)61002-8CrossRefGoogle Scholar
Stelzma, RA, Norman Schnitzlein, H, Murllagh, FR. An English Translation of Alzheimer’s 1907 Paper, ‘Ijber Eine Eigenartige Erlranliung Der Hirnrinde’; Vol 8; 1995. http://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.664.1065&rep=rep1&type=pdf. Accessed 6 February 2019.Google Scholar
Smith, EE. Clinical presentations and epidemiology of vascular dementia. Clin Sci (Lond). 2017;131(11):1059–1068. DOI:10.1042/CS20160607Google Scholar
Hughes, JC. Thinking Through Dementia. Oxford University Press, 2011. DOI:10.1093/med/9780199570669.001.0001Google Scholar
Kalaria, RN. The neuropathology of vascular dementia. In Dementia (eds Ames, D, O'Brien, JT, Burns, A): 643–59. 5th ed. CRC Press, 2017.Google ScholarPubMed
Lobo, A, Launer, LJ, Fratiglioni, L et al. Prevalence of dementia and major subtypes in Europe: a collaborative study of population-based cohorts. Neurologic Diseases in the Elderly Research Group. Neurology. 2000;54(11 Suppl. 5):S4–S9. www.ncbi.nlm.nih.gov/pubmed/10854354. Accessed 6 February 2019.Google ScholarPubMed
Hamilton, RL. Lewy bodies in Alzheimer’s disease: a neuropathological review of 145 cases using alpha-synuclein immunohistochemistry. Brain Pathol. 2000;10(3):378–384. www.ncbi.nlm.nih.gov/pubmed/10885656. Accessed 21 October 2019.CrossRefGoogle ScholarPubMed
Barber, R, Panikkar, A, McKeith, IG. Dementia with Lewy bodies: diagnosis and management. Int J Geriatr Psychiatry. 2001; 16 (Suppl. 1):S12–8. www.ncbi.nlm.nih.gov/pubmed/11748785. Accessed 6 February 2019.Google Scholar
Vann Jones, SA, O’Brien, JT. The prevalence and incidence of dementia with Lewy bodies: a systematic review of population and clinical studies. Psychol Med. 2014; 44(04):673–683. DOI:10.1017/S0033291713000494CrossRefGoogle ScholarPubMed
Savica, R, Grossardt, BR, Bower, JH et al. Incidence of dementia with Lewy bodies and Parkinson disease dementia. JAMA Neurol. 2013; 70(11): 1396. DOI:10.1001/jamaneurol.2013.3579CrossRefGoogle ScholarPubMed
Nelson, PT, Schmitt, FA, Jicha, GA et al. Association between male gender and cortical Lewy body pathology in large autopsy series. J Neurol. 2010;257(11):1875–1881. DOI:10.1007/s00415-010-5630-4Google Scholar
van der Linde, RM, Dening, T, Stephan, BCM et al. Longitudinal course of behavioural and psychological symptoms of dementia: systematic review. Br J Psychiatry. 2016; 209(5): 366–377. DOI:10.1192/bjp.bp.114.148403Google Scholar
Collerton, J, Davies, K, Jagger, C et al. Health and disease in 85 year olds: baseline findings from the Newcastle 85+ cohort study. BMJ. 2009; 339: b4904. DOI:10.1136/bmj.b4904Google Scholar
Kuring, JK, Mathias, JL, Ward, L. Prevalence of depression, anxiety and PTSD in people with dementia: a systematic review and meta-analysis. Neuropsychol Rev. 2018; 28(4): 393–416. DOI:10.1007/s11065-018-9396-2Google Scholar
Kay, DWK, Forster, DP, Newens, AJ. Long-term survival, place of death, and death certification in clinically diagnosed pre-senile dementia in northern England. Br J Psychiatry. 2000;177(2):156–162. DOI:10.1192/bjp.177.2.156Google Scholar
Data Analysis Report: Dying with Dementia. National Dementia Intelligence. https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/733065/Dying_with_dementia_data_analysis_report.pdf. Accessed 21 October 2019.Google Scholar
Xie, J, Brayne, C, Matthews, FE, Medical research council cognitive function and ageing study collaborators. Survival times in people with dementia: analysis from population based cohort study with 14 year follow-up. BMJ. 2008;336(7638):258–262. DOI:10.1136/bmj.39433.616678.25Google Scholar
Mitchell, SL, Kiely, DK, Hamel, MB. Dying with advanced dementia in the nursing home. Arch Intern Med. 2004; 164(3): 321. DOI:10.1001/archinte.164.3.321CrossRefGoogle ScholarPubMed
Sampson, EL, Candy, B, Davis, S et al. Living and dying with advanced dementia: a prospective cohort study of symptoms, service use and care at the end of life. Palliat Med. 2018; 32(3): 668–681. DOI:10.1177/0269216317726443Google Scholar
Ormel, J, VonKorff, M, Ustun, TB et al. Common mental disorders and disability across cultures. Results from the WHO Collaborative Study on Psychological Problems in General Health Care. JAMA. 1994; 272(22): 1741–1748. www.ncbi.nlm.nih.gov/pubmed/7966922. Accessed 8 February 2019.Google Scholar
Beekman, AT, Copeland, JR, Prince, MJ. Review of community prevalence of depression in later life. Br J Psychiatry. 1999;174:307–311. www.ncbi.nlm.nih.gov/pubmed/10533549. Accessed 8 February 2019.Google Scholar
Djernes, JK, Gulmann, NC, Foldager, L, Olesen, F, Munk-Jørgensen, P. 13 year follow up of morbidity, mortality and use of health services among elderly depressed patients and general elderly populations. Aust New Zeal J Psychiatry. 2011;45(8):654–662. DOI:10.3109/00048674.2011.589368Google Scholar
Fiske, A, Wetherell, JL, Gatz, M. Depression in older adults. Annu Rev Clin Psychol. 2009; 5(1): 363–389. DOI:10.1146/annurev.clinpsy.032408.153621Google Scholar
McDougall, FA, Kvaal, K, Matthews, FE et al. Prevalence of depression in older people in England and Wales: the MRC CFA study. Psychol Med. 2007; 37(12): 1787–1795. DOI:10.1017/S0033291707000372Google Scholar
McDougall, FA, Matthews, FE, Kvaal, K, Dewey, ME, Brayne, C. Prevalence and symptomatology of depression in older people living in institutions in England and Wales. Age Ageing. 2007; 36(5): 562–568. DOI:10.1093/ageing/afm111Google Scholar
Royal College of Psychiatrists (RCPsych). Improving the Outcome for Older People Admitted to the General Hospital: Guidelines for the Development of Liaison Mental Health Services for Older People. 2005. www.rcpsych.ac.uk/docs/default-source/members/faculties/liaison-psychiatry/cr183liaisonpsych-every-acute-hospital.pdf?sfvrsn=26c57d4_2. Accessed 21 October 2019.Google Scholar
Koenig, HG, Blazer, DG. Epidemiology of geriatric affective disorders. Clin Geriatr Med. 1992;8(2):235–251. DOI:10.1016/S0749-0690(18)30476-2Google Scholar
Tariot, PN, Podgorski, CA, Blazina, L, Leibovici, A. Mental disorders in the nursing home: another perspective. Am J Psychiatry. 1993; 150(7): 1063–1069. DOI:10.1176/ajp.150.7.1063Google Scholar
Hirschfeld, RMA, Calabrese, JR, Weissman, MM et al. Screening for bipolar disorder in the community. J Clin Psychiatry. 2003;64(1):53–59. DOI:10.4088/jcp.v64n0111CrossRefGoogle ScholarPubMed
Rowland, TA, Marwaha, S. Epidemiology and risk factors for bipolar disorder. Ther Adv Psychopharmacol. 2018;8(9):251–269. DOI:10.1177/2045125318769235CrossRefGoogle ScholarPubMed
Oostervink, F, Boomsma, MM, Nolen, WA. Bipolar disorder in the elderly; different effects of age and of age of onset. J Affect Disord. 2009; 116(3): 176–183. DOI:10.1016/j.jad.2008.11.012Google Scholar
Almeida, OP, Fenner, S. Bipolar disorder: similarities and differences between patients with illness onset before and after 65 years of age. Int Psychogeriatrics. 2002; 14(3): 311–322. www.ncbi.nlm.nih.gov/pubmed/12475092. Accessed 11 February 2019.Google Scholar
Depp, CA JD. Bipolar Disorder in Older Adults: A Critical Review; 2004. https://onlinelibrary.wiley.com/doi/pdf/10.1111/j.1399-5618.2004.00139.x. Accessed 11 February 2019.Google Scholar
Pearlson, G, Rabins, P. The late-onset psychoses: possible risk factors. Psychiatr Clin North Am. 1988; 11(1): 15–32. DOI:10.1016/S0193-953X(18)30514-8Google Scholar
Harris, J, Jeste, D. Late onset schizophrenia: an overview. Schizophr Bull. 1988;14(1). https://watermark.silverchair.com/14-1-39.pdf?token=AQECAHi208BE49Ooan9kkhW_Ercy7Dm3ZL_9Cf3qfKAc485ysgAAAmQwggJgBgkqhkiG9w0BBwagggJRMIICTQIBADCCAkYGCSqGSIb3DQEHATAeBglghkgBZQMEAS4wEQQMvceOJVaLG0qgF17IAgEQgIICF5zX95t5l1-5fbYYWAFNEcw1miHR3xVYimna1ALr3KE4Q4P. Accessed 13 February 2019.Google Scholar
Stafford, J, Howard, R, Kirkbride, JB. The incidence of very late-onset psychotic disorders: a systematic review and meta-analysis, 1960–2016. Psychol Med. 2018; 48(11): 1775–1786. DOI:10.1017/S0033291717003452Google Scholar
Overview | Delirium: prevention, diagnosis and management | Guidance | NICE. www.nice.org.uk/guidance/cg103. Accessed 21 October 2019.Google Scholar
Folstein, MF, Bassett, SS, Romanoski, AJ, Nestadt, G. The epidemiology of delirium in the community: the Eastern Baltimore Mental Health Survey. Int Psychogeriatrics. 1991; 3(2): 169–176. www.ncbi.nlm.nih.gov/pubmed/1811771. Accessed 13 February 2019.Google Scholar
Davis, DHJ, Kreisel, SH, Muniz Terrera, G et al. The epidemiology of delirium: challenges and opportunities for population studies. Am J Geriatr Psychiatry. 2013; 21(12): 1173–1189. DOI:10.1016/j.jagp.2013.04.007CrossRefGoogle ScholarPubMed
Davis, DHJ, Muniz Terrera, G, Keage, H et al. Delirium is a strong risk factor for dementia in the oldest-old: a population-based cohort study. Brain. 2012;135(9):2809–2816. DOI:10.1093/brain/aws190Google Scholar
Blazer, D, George, L HD. The epidemiology of anxiety disorders: an age comparison. – PsycNET. https://psycnet.apa.org/record/1991-97050-002. Published 1991. Accessed 13 February 2019.Google Scholar
Regier, DA, Boyd, JH, Burke, JD et al. One-month prevalence of mental disorders in the United States. Arch Gen Psychiatry. 1988;45(11):977. DOI:10.1001/archpsyc.1988.01800350011002Google Scholar
Andreas, S, Schulz, H, Volkert, J et al. Prevalence of mental disorders in elderly people: the European MentDis_ICF65+ study. Br J Psychiatry. 2017; 210(2): 125–131. DOI:10.1192/bjp.bp.115.180463CrossRefGoogle ScholarPubMed
Mangweth-Matzek, B, Hoek, HW. Epidemiology and treatment of eating disorders in men and women of middle and older age. Curr Opin Psychiatry. 2017;30(6):446–451. DOI:10.1097/YCO.0000000000000356Google Scholar
van Alphen, SPJ, Engelen, GJJA, Kuin, Y, Derksen, JJL. The relevance of a geriatric sub-classification of personality disorders in the DSM-V. Int J Geriatr Psychiatry. 2006; 21(3): 205–209. DOI:10.1002/gps.1451Google Scholar
van Alphen, SPJ (Bas), Derksen, JJL (Jan), Sadavoy, J (Joel), Rosowsky, E (Erlene). Features and challenges of personality disorders in late life. Aging Ment Health. 2012; 16(7): 805–810. DOI:10.1080/13607863.2012.667781Google Scholar
Engels, GI, Duijsens, IJ, Haringsma, R, van Putten, CM. Personality disorders in the elderly compared to four younger age groups: a cross-sectional study of community residents and mental health patients. J Pers Disord. 2003; 17(5): 447–459. www.ncbi.nlm.nih.gov/pubmed/14632377. Accessed 13 February 2019.Google Scholar
Rao, R, Roche, A. Substance misuse in older people. BMJ. 2017; 358: j3885. DOI:10.1136/BMJ.J3885CrossRefGoogle ScholarPubMed
Khan, N, Davis, P, Wilkinson, T, Sellman, JD GP. Drinking patterns among older people in the community: hidden from medical attention? | Request PDF. New Zeal Med J. 2002; 115(1148): 72–75. www.researchgate.net/publication/11450449_Drinking_patterns_among_older_people_in_the_community_Hidden_from_medical_attention. Accessed 21 October 2019.Google Scholar
Kuerbis, A, Sacco, P, Blazer, DG, Moore, AA. Substance abuse among older adults. Clin Geriatr Med. 2014;30(3):629–654. DOI:10.1016/j.cger.2014.04.008Google Scholar
Cadieux, RJ. Drug interactions in the elderly. Postgrad Med. 1989;86(8):179–186. DOI:10.1080/00325481.1989.11704506CrossRefGoogle ScholarPubMed
Hinkin, CH, Castellon, SA, Dickson-Fuhrman, E, Daum, G, Jaffe, J, Jarvik, L. Screening for drug and alcohol abuse among older adults using a modified version of the CAGE. Am J Addict. 2001; 10(4): 319–326. www.ncbi.nlm.nih.gov/pubmed/11783746. Accessed 21 October 2019.Google Scholar
Gunnell, D, Middleton, N, Whitley, E, Dorling, D, Frankel, S. Why are suicide rates rising in young men but falling in the elderly? A time-series analysis of trends in England and Wales 1950–1998. Soc Sci Med. 2003;57(4):595–611. www.ncbi.nlm.nih.gov/pubmed/12821009. Accessed 20 February 2019.Google Scholar
Office for National Statistics. Suicides in the UK: 2017 registrations. ONS. 2017.Google Scholar
Measuring National Well-being – Office for National Statistics. www.ons.gov.uk/peoplepopulationandcommunity/wellbeing/articles/measuringnationalwellbeing/qualityoflifeintheuk2018. Accessed 21 October 2019.Google Scholar
Howard, R, Rabins, PV, Seeman, MV, Jeste, V. Late-Onset Schizophrenia and Very-Late-Onset Schizophrenia-Like Psychosis: An International Consensus and the International Late-Onset Schizophrenia Group. Vol 157; 2000. https://ajp.psychiatryonline.org/doi/pdfplus/10.1176/appi.ajp.157.2.172. Accessed 19 February 2019.Google Scholar
Katzman, R. Education and the prevalence of dementia and Alzheimer’s disease. Neurology. 1993;43: 13–20.Google Scholar
Staff, R, Hogan, M, Williams, D, et al. Intellectual engagement and cognitive ability in later life (the ‘use it or lose it’ conjecture): longitudinal, prospective study. BMJ. 2018;363: k4925.Google ScholarPubMed
Burn, K, Szoeke, C. Is grandparenting a form of social engagement that benefits cognition in ageing? Maturitas. 2015;80: 122–5.Google Scholar
Daw, EW, Payami, H, Nemes, EJ, et al. The number of trait loci in late onset Alzheimer disease. American Journal of Human Genetics. 2000;66: 196–204.Google Scholar
Breteler, MM. Vascular risk factors for Alzheimer’s disease: an epidemiological perspective. Neurobiology of Aging. 2000;21: 153–60.CrossRefGoogle Scholar

Save book to Kindle

To save this book to your Kindle, first ensure coreplatform@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×