The Incidence of Nonaffective, Nonorganic Psychotic Disorders in Older People: A Population-based Cohort Study of 3 Million People in Sweden

We examined VLOSLP incidence by age, sex, region of origin, income, partner or child death, birth period, and sensory impairments. ResultsWe identified 14 977 cases and an overall incidence of 37.7 per 100 000 person-years at-risk (95% CI = 37.1 –38.3), with evidence that rates increased more sharply with age for women (likelihood ratio test: χ2(6) = 31.56,P< .001). After adjustment for confounders, rates of VLOSLP were higher among migrants from Africa (hazard ratio [HR] = 2.0, 95% CI = 1.4 –2.7), North America (HR = 1.4, 95% CI = 1.0–1.9,P = .04), Europe (HR = 1.3, 95% CI = 1.2 –1.4), Russian-Baltic regions (HR = 1.6, 95% CI = 1.4–1.9), and Finland (HR = 1.6, 95% CI = 1.5–1.7). VLOSLP risk was highest for those in the lowest income quartile (HR = 3.1, 95% CI = 2.9–3.3). Rates were raised in those whose partner died 2 years before cohort exit (HR = 1.1, 95% CI = 1.0 –1.3,P = .02) or whose child died in infancy (HR = 1.2, 95% CI = 1.0 –1.4,P = .05), those without a partner (HR = 1.9, 95% CI = 1.8 –1.9) or children (HR = 2.4, 95% CI = 2.3–2.5), and those whose child had a psychotic disorder (HR = 2.4, 95% CI = 2.2–2.6). InterpretationWe identified a substantial burden of psychosis incidence in old age, with a higher preponderance in women and most migrant groups. Life course exposure to environmental factors including markers of deprivation, isolation, and adversity were associated with VLOSLP risk.
Source: Schizophrenia Bulletin - Category: Psychiatry Source Type: research