Seniors are twice as likely to receive psychotropic prescriptions than younger adults but are much less likely to receive mental health care from psychiatrists or to receive psychotherapy, according to a recent study published in the Journal of the American Geriatrics Society.
“Our findings suggest that psychotropic medication use is widespread among older adults in outpatient care, at a far higher rate than among younger patients,” the study’s lead author Dr. Maust said in a press release. “In many cases, especially for milder depression and anxiety, the safer treatment for older adults who are already taking multiple medications for other conditions might be more therapy-oriented, but very few older adults receive this sort of care.”
Maust, and his team from the University of Michigan Medical School and VA Ann Arbor Healthcare System, used CDC and Census data to analyze 100,661 doctors visits. The researchers compared different trends in mental health care in adults between 21 and 64 years of age and those over 65, accounting for psychotropic drug prescriptions, mental disorder diagnoses, psychiatrist visits, and psychotherapy.
The results showed that seniors had twice the rate of visits related to antidepressant and anti-anxiety prescriptions than younger adults but saw psychiatrists at half the rate. The analysis, according to Maust, suggests “the possibility of overtreatment,” in seniors, “especially given the changing balance of risk and benefit as patients age.”
Covering this study for WBUR’s CommonHealth Blog, Nell Lake points to the possibility that these trends may be driven by reimbursement systems, the perception that newer antidepressants are safer, and the increased contact seniors have with the doctors in general.
“The elderly population is booming, and seniors use the health care system more than any other demographic,” she writes. “So, finding safe, effective and appropriate treatments for their mental health problems is critical — for the well-being of a large swath of people, and as a policy matter.”
Maust, D. T., Kales, H. C., & Blow, F. C. (2015). Mental Health Care Delivered to Younger and Older Adults by Office‐Based Physicians Nationally. Journal of the American Geriatrics Society, 63(7), 1364-1372. (Abstract)
Yes, this seems to be true. My mother was prescribed Neurontin, an anti-convulsant used for alleged bi-polar disorder” for arthritis related back pains in addition to other drugs from a well respected local bone physician. It also seems that many other older people had been prescribed the same drug for essentially the same reason. Thank God, she refused to take it. She is eighty years old. This is a definite problem to watch out for and be concerned with and now that she is older, I will try to pay more attention to what she is prescribed and taking. However, she is an independent. controlling sort and sometimes wishes to control me’ so, it will be an adventure. And no matter the harm and emotional abuse; she has heaped on me; I will do my best to see she is not harmed by unscrupulous doctors taking advantage of a widowed eighty year old women. If they can’t get to the children or the parents, they try the elderly or grandparents.
That is true. I also have to monitor the drugs pushed on my family and try to convince them not to take some really useless and harmful ones. Some drugs do help and having a family member with type I diabetes I know they can be life saving but the real tragedy is that the system is so corrupt that you can’t tell what’s good and what will kill you anymore.
from the abstract:
RESULTS: Older adults had a smaller proportion than younger adults of visits with a mental disorder diagnosis (4.8% vs 9.5%). So it is not only that older adults get 2x the Rx rate of these drugs compared to younger people: they have half the rate of Dx compared to younger people, along with 2x the rate of prescriptions.