Psychiatric disorders (DSM-III) and cognitive impairment among the elderly in a U.S. urban community

Results are presented on the current prevalence rates of psychiatric disorder in 2,588 non-institutionalized persons aged 65 and older who were drawn from a probability sample of New Haven, Connecticut, and 12 surrounding towns in South Central Connecticut. Based on the Diagnostic Interview Schedule (DIS), 6.7% of the respondents had a psychiatric diagnosis (DSM-III), and based on the Mini-Mental Status Exam (MMS), 3.4% had severe cognitive impairments during the past 6-month period. Therefore, more than 10% currently had either a psychiatric or a severe cognitive problem. Overall, these rates of psychiatric disorders are lower than those found in adult populations under age 65. As with younger samples, anxiety and affective disorders were among the most common psychiatric problems. The majority of elderly reported themselves in good emotional and physical health and felt they had sufficient finances to meet their needs. The rate of severe cognitive impairment did not increase until after age 79. Among those 80 years and older, cognitive impairments were more common in women than men, probably due to differential survival rates. Since less than 6% of the elderly sample are living in institutions these results among non-institutionalized elderly point to the relative psychiatric well-being of the majority of the elderly. However, in view of the longer life expectancy, the next decade will see an increase in the absolute number of persons with cognitive impairments.