The epidemiology of common late-life mental disorders in the community: Themes for the new century

Objective: The prevalence and incidence of the major mental disorders of late life that are common in the community and in primary health care are reviewed. Methods: Community-based studies in English that included older adults were identified through MEDLINE searches and were reviewed. Results: As the population ages, dementia, depression, and other mental conditions of the aged will demand more attention from clinicians and investigators to minimize their effects on disability, the use of health care services, and the quality of life for older adults and caregivers. Up to 15 to 20 percent of older adults have significant depressive symptoms, and it is estimated that as many as 45 percent of persons age 85 years and older have significant cognitive impairment and dementia. Other mental-health-related conditions, such as anxiety disorders, alcohol abuse, and prescription medicine misuse, are also important considerations but have not been as well studied as depression and dementia. Because an increasing proportion of older adults are members of minority groups, clinicians need to increase their awareness of how cultural factors relate to risk for mental disorders in late life. Conclusions: Attention to three themes may help clinicians and investigators meet the challenge of treating the common mental disorders of later lif: the effect of these disorders on functioning, prevention of the consequences of mental disorders, and integration of mental health care and primary health care services.