Long-term care utilization within older adults with schizophrenia: Associated factors in a multicenter study. (February 2022)

• Record Type: Journal Article
• Authors: Lavaud, Pierre; McMahon, Kibby; Sánchez Rico, Marina; Hanon, Cécile; Alvarado, Jesús M.; de Raykeer, Rachel Pascal; Limosin, Frédéric; Hoertel, Nicolas
• Is Part Of: Psychiatry research. Volume 308(2022)
• Publication Date: 2022-02
• Subjects: Long-term care facility -- Schizophrenia -- Older -- Depression -- Cognition; Psychiatry -- Periodicals; Psychiatry -- periodicals; Psychiatrie -- Périodiques; 616.89
• DOI: 10.1016/j.psychres.2021.114339
• Languages: English
• ISSNs: 0165-1781

Abstract

Highlights: Schizophrenia in later life is marked by fluctuations both in symptomatology and functioning. Long-term care utilization within older adults with schizophrenia is significantly and independently associated with depression. Long-term care utilization is associated with higher rates of physical comorbidities, greater consumption of psychotropic medication, and poorer quality of life. Older institutionalized adults with schizophrenia have a lower likelihood of consulting a general practitioner in the past year. Abstract: Objective: Data are scarce regarding the clinical factors associated with utilization of long-term care facilities among older adults with schizophrenia. In this multicenter study, we sought to examine potential clinical differences between older adults with schizophrenia who are living in a long-term care facility and their community-dwelling counterparts. Method: We used data from the French Cohort of individuals with Schizophrenia Aged 55-years or more (CSA) study, a large multicenter sample of older adults with schizophrenia ( N = 353). Results: The prevalence of long-term care utilization was 35.1% of older patients with schizophrenia. Living in a long term care facility was significantly and independently associated with higher level of depression (Adjusted odds ratio (AOR) [95%CI]=1.97 [1.06–3.64]), lower cognitive (AOR [95%CI]=0.94 [0.88–0.99]) and global functioning (AOR [95%CI]=0.97 [0.95–0.99]), greater lifetime number of hospitalizations in a psychiatric department (AOR [95%CI]=2.30 [1.18–4.50]), not having consulted a general practitioner in the past year (AOR [95%CI]=0.28 [0.0.14–0.56]), urbanicity (AOR [95%CI]=2.81 [1.37–5.80]), and older age (AOR [95%CI]=1.08 [1.03–1.13]). Discussion: Older patients with schizophrenia who live in long-term care facilities appear to belong to a distinct group, marked by a more severe course of illness with higher level of depression and more severe cognitive deficits than older patients with schizophrenia living in other settings. Our study highlights the need of early assessment and management of depression and cognitive deficits in this population and the importance of monitoring closely this vulnerable population.