Long-term Care Utilization and All-cause Mortality among Older Adults with Major Psychiatric Disorders: A 5-year Prospective Multicenter Study.

Abstract

Objective: As the population ages, the number of older adults with psychiatric disorders in long-term care facilities is expected to importantly increase. To our knowledge, no study to date has examined the association of long-term care utilization with all-cause mortality among older adults with psychiatric disorders.

Methods: In this report, we used data from the "Cohort of individuals with Schizophrenia, bipolar and major depressive disorder aged 55 years or more (CSA)", a 5-year prospective multicenter study, to examine this association. All analyses were adjusted for a wide range of potential confounders, including sociodemographic and clinical characteristics, and psychotropic medication use.

Results: The prevalence of long-term care utilization was 23.6% (n=132) among 559 older adults with major psychiatric disorders. Living in long-term care utilization was significantly and independently associated with increased all-cause mortality in both the crude (OR=2.54; 95%CI=1.67-3.87; p<0.001) and fully-adjusted multivariable logistic regression models (AOR=1.86; 95%CI=1.10-3.16; p=0.021). This association did not significantly vary across most subgroups defined by sociodemographic and clinical characteristics.

Conclusions: In this multicenter prospective observational study of older adults with major psychiatric disorders, long-term care utilization was significantly associated with increased all-cause mortality. Physicians and policy makers should take this association under careful consideration.