Mortality rates elevated in elderly schizophrenia patients
MedWire News: The overall mortality rate among elderly patients with schizophrenia is more than twice that in the general elderly population, results from a Finnish study show.
Writing in the International Journal of Geriatric Psychiatry, Tiina Talaslahti (Helsinki University Central Hospital) and team observe: "Studies concerning mortality of schizophrenia patients over 65 years old are rare, or detailed information is limited."
They add that "this issue needs special attention," as "the number of older patients with schizophrenia is expected to double during the next 2 decades."
The researchers therefore studied mortality rates between 1999 and 2008 among 9461 patients with the mental health disorder who were aged 65 years or older in 1999.
The findings were compared with mortality rates in the age- and gender-matched general population over the same period, and expressed as standard mortality ratios (SMRs).
In total, 5596 (59%) elderly patients with schizophrenia died over the study period, including 66% of men and 56% of women, and 4.7% of these deaths were unnatural, such as accidents and suicides. The mean age at death was significantly higher in women than men, at 79.9 versus 76.5 years.
The overall mortality rate was significantly higher in schizophrenia patients than the general population, at an SMR of 2.69, with schizophrenic men having higher overall mortality rates than women with the disorder, at SMRs of 3.00 and 2.55, respectively.
The SMR for natural causes of death in schizophrenia patients was 2.58, with higher rates in men than women, at SMRs of 2.87 and 2.45, respectively. Regarding unnatural causes of death, the overall SMR in schizophrenia patients was 11.04, with men again showing higher rates than women, at SMRs of 11.52 and 10.78, respectively.
Of the schizophrenia patients who died during follow-up, 1709 (31%) had at least one psychiatric hospitalization in the 5 years before follow-up. The overall SMR was significantly higher in this group than in those with no psychiatric hospitalizations, at 3.92 versus 2.37.
"In the present study, mortality among the nearly 10,000 older patients with schizophrenia was almost three times higher than in age-matched and sex-matched general population," summarize Talaslahti and colleagues.
"Therefore, in older patients with schizophrenia, both physical and psychiatric health as well as the adverse effects of medications should be carefully monitored and treated," they conclude.
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By Mark Cowen