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Primary care promotes wellness and prevents disease. This care includes health promotion, education, protection (such as immunizations), early disease screening, and environmental considerations. Settings providing this type of healthcare include physician offices, public health clinics, school nursing, and community health nursing.
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Disease surveillance is the systematic collection, analysis, and interpretation of health data essential to the planning, implementation, and evaluation of public health practice. This process integrates data dissemination to entities responsible for preventing and controlling disease, injury, and disability. Surveillance systems provide crucial information for action, helping public health authorities make informed decisions to manage and prevent outbreaks, ensure public safety, optimize...
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Public Health.

Shilpa Srinivasan1, Charlotte Imlach2, Julie J Royer3

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Alzheimer's Disease and Related Disorders (ADRD) are common in individuals with severe mental illness (SMI), increasing mortality. ADRD prevalence is higher in schizophrenia patients compared to other SMI groups.

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Area of Science:

  • Neuroscience
  • Psychiatry
  • Public Health

Background:

  • Epidemiological studies indicate a potential higher risk of cognitive decline and dementia in individuals with severe mental illness (SMI).
  • Limited data exists on dementia prevalence within SMI populations, especially in the U.S. public psychiatry sector.
  • The South Carolina Alzheimer's Disease and Related Disorders (ADRD) Registry offers a unique resource for this investigation.

Purpose of the Study:

  • To assess the prevalence of ADRD in adults with SMI.
  • To examine associated clinical outcomes, including mortality and healthcare utilization.
  • To compare ADRD prevalence in schizophrenia patients versus other SMI diagnoses.

Main Methods:

  • Analysis of de-identified patient data from the South Carolina Department of Mental Health (SCDMH) for individuals aged 55+ (FY 2018-2022).
  • Linking SCDMH data with the South Carolina Alzheimer's Disease Registry and the Revenue and Fiscal Affairs (RFA) data warehouse.
  • Comparison of individuals with SMI and ADRD to age/sex/race-matched individuals with SMI without ADRD.

Main Results:

  • A total of 24,291 individuals with SMI received services; 64.8% were female, 58% White, 37.6% Black.
  • Yearly ADRD prevalence in the SMI population ranged from 9.7-17%.
  • Alzheimer's Disease (AD) prevalence was significantly higher in individuals with schizophrenia compared to other SMI diagnoses (p < 0.0001).
  • Mortality rates were significantly higher in individuals with SMI and ADRD compared to SMI only (p < 0.0001).

Conclusions:

  • Alzheimer's Disease and Related Disorders are prevalent in individuals with SMI and are linked to increased mortality.
  • ADRD is more common in individuals diagnosed with schizophrenia than in those with other SMI.
  • Findings underscore the need for further research into ADRD within SMI populations to inform patient care and service delivery.