Mortality and mental disorders in a Spanish elderly population

Abstract

Objective: To analyse the relationship between mental disorders and mortality rates in the elderly community of Zaragoza, Spain.

Methods: Baseline, cross-sectional study (two-stage screening) of a representative, stratified sample (N=1080) of the elderly (65+ years) living in the community. Follow-up study (4.5 years).

Instruments: Spanish versions of Geriatric Mental State, AGECAT computerized diagnostic program and Mini-Mental Status Examination.

Results: Two hundred and sixteen subjects died during the follow-up period (global mortality rate 4.8% per year). Using a logistic regression model with sex, age, educational level, physical illness and AGECAT diagnoses as explanatory variables and alive/dead as response, the following odds ratios (95% confidence intervals in parentheses) were obtained (reference group: non-cases): 'subcases' 1.3 (0.9-2.0), 'organic' (dementia) 3.7 (2.0-6.7), global depression 3.0 (1.7-5.3), 'psychotic' depression (melancholic type) 3.7 (1.7-8. 4), 'neurotic' depression 2.7 (1.4-5.3) and 'neuroses' 0.8 (0.2-3.6). Both pure 'organic' and pure 'depressed' cases had higher mortality when compared with comorbidity cases.

Conclusion: There is a significant association between psychiatric morbidity and mortality in the elderly living in a Spanish community. Mortality risk in psychiatric cases are higher than previously reported in the literature.