The three year course of psychiatric problems in a geriatric population

This is a 3 year follow-up of the psychiatric status of 276 men age 65 and older who were originally seen as medical and surgical patients. Major psychiatric diagnoses were noted in 24% of the individuals, these being fairly evenly divided between active alcoholism, affective disorder, atherosclerotic dementia, or a past history of alcoholism, and a heterogeneous category, composed mostly of individuals with senile dementia. Over the 3 years, approximately one-quarter of the sample who had originally been free of psychopathology became ill, most with an affective disorder or an organic brain syndrome. A high level of diagnostic consistency was noted over 3 years for the individuals originally noted to be psychiatrically ill. The follow-up demonstrated an unexpectedly bleak prognosis for the individuals with affective disorder. The reasons for this finding are explored.