Long-term care utilization and all-cause mortality among older adults with major psychiatric disorders: a 5-year...

As the population ages, the number of older adults with psychiatric disorders in long-term care facilities is expected to significantly increase. To our knowledge, no study has examined the association between long-term care utilization and all-cause mortality among older adults with psychiatric disorders.

In this report, we used data from the Cohort of Individuals with Schizophrenia, Bipolar and Major Depressive Disorder Aged 55 Years or More, a 5-year prospective multicenter study, to examine this association. All analyses were adjusted for a wide range of potential confounders, including sociodemographic and clinical characteristics and psychotropic medication use.

The prevalence of long-term care utilization was 23.6% (n=132) among 559 older adults with major psychiatric disorders. Living in a long-term care facility was significantly and independently associated with increased all-cause mortality in both the crude (OR = 2.54; 95%CI 1.67-3.87; p < 0.001) and fully-adjusted multivariable logistic regression models (AOR = 1.86; 95%CI 1.10-3.16; p = 0.021). This association did not vary significantly across most subgroups defined by sociodemographic and clinical characteristics.

In this multicenter prospective observational study of older adults with major psychiatric disorders, long-term care utilization was significantly associated with increased all-cause mortality. Physicians and policy makers should take this association under careful consideration.