Abstract
OBJECTIVE: As the population ages, the number of older adults with psychiatric disorders in long-term care facilities is expected to significantly increase. To our knowledge, no study has examined the association between long-term care utilization and 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, 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 a long-term care facility 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 vary significantly across most subgroups defined by sociodemographic and clinical characteristics. CONCLUSION: 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.