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Older adults more likely to take psychotropic medications, less likely to visit psychiatrist

Medications for mental health are more commonly used among adults aged older than 65 years, despite rarely receiving care from psychiatrists, compared to their younger counterparts, according to recently published data.

“Our findings suggest that psychotropic medication use is widespread among older adults in outpatient care, at a far higher rate than among younger patients. 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,” Donovan Maust, MD, MS, of the department of psychiatry, University of Michigan, said in a press release. 

Donovan Maust

To assess differences in mental health care among younger (21 to 64 years) and older (aged 65 years and older) adults, researchers analyzed data from the National Ambulatory Medical Care Survey.

Results demonstrated that in office settings, mental health diagnoses were more common among younger adults (9.5%) compared with older adults (4.8%). Additionally, younger adults were more likely to have a mental health diagnosis at psychotropic visits compared with older adults (36.8% vs 19.3%). 

Psychotherapy was much less likely to be utilized by older adults compared with younger adults (P < .001). However, older adults were significantly more likely to see a primary care provider for psychotherapy (20.3%) compared with younger adults (9.6%). 

Prescriptions for mental health medications were received by older adults at nearly twice the rate of younger adults, according to the study. 

Older adults were much less likely to receive a psychotropic medication prescription from a psychiatrist, with only 4.4% of visits being to a psychiatrist, compared with 17.1% for younger adults.

The researchers noted the importance of providing mental health management training to non-psychiatrist providers, as many older patients refer to them for health care needs, rather than specialists. Additionally, since comorbidity, sensitivity to medication and heightened risk for adverse events are more common among seniors, it is vital that providers be aware of where and what type of treatment is being received. 

“While it’s still true that we have patients who are not getting treated for mental health concerns, these data suggest that we also need to be mindful of the possibility of overtreatment, especially given the changing balance of risk and benefit as patients age. Collaborative care efforts in primary care that seeks to create structure and support for these patients, along with appropriate reimbursement for this type of service, could be key,” Maust said in the release. – by Casey Hower

Disclosures: The researchers report no relevant financial disclosures.