Related paper presentation: Findings from the initial analysis for this manuscript were presented at the 63rd Annual Scientific Meeting of the Gerontological Society of America, New Orleans, LA, November 2010.
Chronic Physical Conditions in Older Adults with Mental Illness and/ or Substance Use Disorders
Article first published online: 13 SEP 2011
© 2011, Copyright the Authors Journal compilation © 2011, The American Geriatrics Society
Journal of the American Geriatrics Society
Volume 59, Issue 10, pages 1913–1921, October 2011
How to Cite
Lin, W.-C., Zhang, J., Leung, G. Y. and Clark, R. E. (2011), Chronic Physical Conditions in Older Adults with Mental Illness and/ or Substance Use Disorders. Journal of the American Geriatrics Society, 59: 1913–1921. doi: 10.1111/j.1532-5415.2011.03588.x
- Issue published online: 18 OCT 2011
- Article first published online: 13 SEP 2011
- mental illness;
- substance use disorder;
- chronic condition;
To examine the association between mental illness and chronic physical conditions in older adults and investigate whether co-occurring substance use disorders (SUDs) are associated with greater risk of chronic physical conditions beyond mental illness alone.
A retrospective cross-sectional study.
Medicare and Medicaid programs in Massachusetts.
Massachusetts Medicare and Medicaid members aged 65 and older as of January 1, 2005 (N = 679,182).
Diagnoses recorded on Medicare and Medicaid claims were used to identify mental illness, SUDs, and 15 selected chronic physical conditions.
Community-dwelling older adults with mental illness or SUDs had higher adjusted risk for 14 of the 15 selected chronic physical conditions than those without these disorders; the only exception was eye diseases. Moreover, those with co-occurring SUDs and mental illness had the highest adjusted risk for 11 of these chronic conditions. For residents of long-term care facilities, mental illness and SUDs were only moderately associated with the risk of chronic physical conditions.
Community-dwelling older adults with mental illness or SUDs, particularly when they co-occurred, had substantially greater medical comorbidity than those without these disorders. For residents of long-term care facilities, the generally uniformly high medical comorbidity may have moderated this relationship, although their high prevalence of mental illness and SUDs signified greater healthcare needs. These findings strongly suggest the imminent need for integrating general medical care, mental health services, and addiction health services for older adults with mental illness or SUDs.