Screening for syphilis in an aged psychiatrically impaired population

A serum Venereal Disease Research Laboratories (VDRL) test was carried out in 216 elderly patients with dementia or "functional" psychiatric illness, or both, as part of a community based screening program. The VDRL test was positive in 13 patients, 11 of whom (5.1 percent) had an actual past or present syphilitic infection as confirmed by the fluorescent treponemal antibody absorption test (FTA-Abs). In six patients (2.8 percent) syphilis was newly detected, and in another two patients previously detected syphilis had been inadequately treated. Only two (0.9 percent) biologic false positive reactors were detected. These results question the belief that aging per se is a common cause of the biologic false positive reaction; and indicate a relatively high incidence of past or present syphilitic infection in geriatric patients with psychiatric illness in the community who have been referred for crisis intervention.