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Utilization of psychiatric consultation for elderly patients
Journal of the American Geriatrics Society
|October 1, 1983
Summary
Elderly patients experience higher rates of cognitive impairment and depression, yet are referred for psychiatric consultations less often than younger patients. This suggests a potential underdiagnosis and undertreatment of mental health conditions in older hospital populations.
Area of Science:
- Geriatric Psychiatry
- Hospital Psychiatry
- Mental Health Services Research
Background:
- Cognitive impairment and depression are prevalent in elderly patients.
- Psychiatric disorders, particularly cognitive disorders, increase with age.
- Elderly patients occupy a significant portion of hospital beds.
Purpose of the Study:
- To review psychiatric consultations in a hospital setting over one year.
- To determine the prevalence of cognitive and emotional disorders in elderly patients.
- To compare psychiatric referral rates between elderly and younger patients.
Main Methods:
- Retrospective review of 651 psychiatric consultations.
- Point prevalence study using Mini-Mental State Exam and General Health Questionnaire.
- Analysis of consultation data stratified by age.
Main Results:
- 54% of elderly patients studied had cognitive impairment; 27% had depression.
- Cognitive disorders were more common in the elderly, while emotional disorders had similar prevalence across age groups.
- Elderly patients (over 60) constituted 21% of consultations but occupied 28.5% of beds.
Conclusions:
- Elderly patients are underrepresented in psychiatric consultations relative to their hospital bed occupancy.
- Despite higher incidence of psychiatric disorders, older patients are less frequently referred for psychiatric evaluation.
- There is a need to improve psychiatric assessment and referral for elderly patients in hospitals.