Prevalence and Correlates of Psychiatric Disorders among Older Adults

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DESCRIPTION (provided by applicant): The "graying of America" represents an unprecedented demographic trend whereby the population of Americans aged 55 or older is increasing rapidly. Therefore, it is important to identify the mental health needs of older Americans as they move toward later life. By understanding the incidence, prevalence, correlates, and treatment needs of psychiatric disorders among older adults, researchers can make greater inroads to more efficiently direct limited preventive and treatment resources. Few investigations have an epidemiological sample of older adults to permit adequate estimation of the patterns and correlates of geriatric psychiatric disorders, including those disorders that are "sub-threshold" and do not meet established diagnostic criteria but may be extremely disabling. Physical illnesses, which may be extremely stressful psychosocial events, are also more present during older adulthood, and additional information is lacking regarding the onset of psychiatric disorders resulting from medical conditions. This RO3 application, submitted by a new investigator, seeks to overcome these limitations by bringing together an interdisciplinary team of epidemiological and clinical researchers to focus on geriatric mental health. This application proposes secondary analyses of the subset of older adults (n=13,420) within the National Epidemiologic Survey on Alcohol and Related Conditions (2001-2002) (NESARC) to examine the broader issues of incidence, prevalence, correlates, and treatment of mental disorders among older adults (aged 55 or older). The NESARC is unique because it contains comprehensive assessments of psychiatric disorders in a nationally representative sample of older adults. The specific aims are to: (1) Estimate the prevalence and demographic correlates (e.g., marital status, gender, race, employment, and education) of psychiatric mood and anxiety disorders during older adulthood (aged 55 or older) for the following the disorder subtypes: (a) independent of medical or substance abuse (IDs) and (b) medically induced disorders (MIDs); We will also examine subthreshold disorders within each disorder group. (2) Examine the demographic and clinical factors (e.g. symptom profile, number and length of episodes) that differentiate the structure of psychiatric disorder subtypes among older adults based on: (a) patterns of co-morbidity (e.g. pure versus co-morbid) and (b) early (i.e. less than age 55) versus late onset (i.e. age 55 or older) disorders; and (3) Estimate the patterns of treatment utilization among disorder subtypes. Information learned from this study will help assess the degree to which unique screening and intervention efforts are needed across disorder subtypes. Issues addressed in this proposal are in concert with the scientific agenda for mental health and aging research promoted by National Institute of Mental Health, Mental Illnesses in Older Adults (PA-03-014).