Chronic physical conditions in older adults with mental illness and/ or substance use disorders
UMass Chan Affiliations
Clinical and Population Health ResearchCenter for Health Policy and Research
Department of Family Medicine and Community Health
Document Type
Journal ArticlePublication Date
2011-09-13Keywords
AgedAged, 80 and over
Chronic Disease
Comorbidity
Cross-Sectional Studies
Female
Health Surveys
Humans
Male
Massachusetts
Medicaid
Medicare
Mental Disorders
Retrospective Studies
Risk
Substance-Related Disorders
United States
Community Health and Preventive Medicine
Preventive Medicine
Primary Care
Metadata
Show full item recordAbstract
OBJECTIVES: 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. DESIGN: A retrospective cross-sectional study. SETTING: Medicare and Medicaid programs in Massachusetts. PARTICIPANTS: Massachusetts Medicare and Medicaid members aged 65 and older as of January 1, 2005 (N = 679,182). MEASUREMENTS: Diagnoses recorded on Medicare and Medicaid claims were used to identify mental illness, SUDs, and 15 selected chronic physical conditions. RESULTS: 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. CONCLUSION: 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. Geriatrics Society.Source
Epub 2011 Sep 13. Link to article on publisher's siteDOI
10.1111/j.1532-5415.2011.03588.xPermanent Link to this Item
http://hdl.handle.net/20.500.14038/30873PubMed ID
22091505Related Resources
Link to Article in PubMedae974a485f413a2113503eed53cd6c53
10.1111/j.1532-5415.2011.03588.x