[Social and environmental factors and mental health in the elderly]

The paper gives data on trends in the prevalence of mental disease and disorders incidence in old age groups for 10 years (1984-1994) and analyzes whether macro- and microsocial factors can affect mental health in the elderly. Clinical and epidemiological surveys of 1109 examinees aged 60 years and older residing in a limited Moscow area have yielded morbidity rates for mental disease and disorders (including those by sex and age) in the population. Diagnoses was rated according to the International Classification of Disease (ICD-10). Varying mental disorders and nosological entities (without taking into account abnormalities) were found in 36.6% of examinees, including 6.1% with psychotic states, i.e. proper psychoses and clinical mental deficiency. Comparison of the results of two studies. One study was carried out in the 1980s and the present one performed 10 years later, that is, within the period of socioeconomic changes in the country, is indicative of a considerable growth of the morbidity rates in nonpsychotic forms of psychopathology of cerebrovascular genesis and psychogenic affective disorders among the Moscow elderly population. A correlation between the incidence of psychic pathology at an elderly age and different socioenvironmental factors has been studied. There are significant differences in accumulation of stress-induced life events in elderly patients with different psychopathology types. The obtained results confirm the author's assumption that the growth of psychic disorder morbidity rates, specifically, in non-psychotic forms of mental diseases of cerebrovascular genesis and psychogenic affective disorders in the past decade may be caused by increased stress-induced load on elderly people both in connection with unfavorable socioeconomic conditions of the reform epoch and a frustration of their outlook stereotypes. In the authors' opinion, their hypothesis on the correlation between the increase in the incidence of some psychogeriatric diseases and the frequency of stress-induced factors, needs further testing, in particular, by way of prospective population clinical and epidemiological studies.