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Psychiatric status among the homebound elderly: an epidemiologic perspective
1Department of Epidemiology and Public Health, Yale University.
Journal of the American Geriatrics Society
|June 1, 1992
Summary
Homebound elderly individuals show higher rates of cognitive impairment, depression, dysthymia, and anxiety disorders compared to their non-homebound peers. Dysthymia remains significantly more prevalent even after accounting for health status.
Area of Science:
- Gerontology
- Psychiatry
- Public Health
Background:
- Homebound elderly individuals represent a vulnerable population with unique health challenges.
- Understanding the prevalence of psychiatric disorders in this group is crucial for targeted interventions.
Purpose of the Study:
- To compare the prevalence of specific psychiatric disorders in homebound elderly individuals versus non-homebound elders.
- To control for demographic, physical health, and socio-economic factors in this comparison.
Main Methods:
- A survey design was employed within the Epidemiologic Catchment Area (ECA) project in New Haven, CT.
- 2,553 non-institutionalized elders were assessed using the Diagnostic Interview Schedule (DIS) for psychiatric status (DSM III) and the Mini-Mental Status Examination for cognitive status.
Main Results:
- Homebound elders exhibited significantly higher prevalence rates for cognitive impairment (21.8% vs 11.0%), depression (2.3% vs 0.7%), dysthymia (3.9% vs 1.7%), and anxiety disorders (2.2% vs 0.4%).
- After controlling for physical health status, only dysthymia remained significantly more prevalent in the homebound group (Odds ratio = 2.1).
Conclusions:
- The elevated prevalence of psychiatric disorders among homebound elders underscores the need for routine psychiatric assessments in primary care for this population.
- Increased availability of preventive and therapeutic psychiatric services for homebound elders is recommended.