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Comorbid disorders more likely in older patients with schizophrenia

In a 10-year sample of older patients, those with schizophrenia had significantly higher rates of dementia, congestive heart failure, chronic obstructive pulmonary disease and hypothyroidism, but lower rates of cancer.

The study sample was composed of adults aged at least 65 years who received care at Wishard Health Services in Indiana between 1999 and 2008. Patients were diagnosed with schizophrenia (n=1,635) or without (n=30,831).

The mean number of years of follow-up for the schizophrenia group was 5.66 years and 6.69 years for the group without schizophrenia.

Compared with patients without schizophrenia, those with schizophrenia were more likely to have a history of smoking, substance abuse or excessive alcohol consumption. They were also a bit younger, and were more likely to be female and black.

Schizophrenia was associated with significantly higher rates of congestive heart failure (45.05% vs. 38.84%), chronic obstructive pulmonary disease (COPD; 52.71% vs. 41.41%), diabetes (55.75% vs. 45.59%), and hypothyroidism (36.72% vs. 26.73%).

Conversely, researchers found a lower cancer rate in patients with schizophrenia vs. those without, 30.8% vs. 43.2%.

After controlling for cancer diagnoses, congestive heart failure, COPD, liver disease, alcoholism, smoking and age, researchers found schizophrenia was associated with all-cause mortality, with an HR of 1.25. According to researchers, this translates to a 25% increase in the risk for death among patients with schizophrenia.

A dementia diagnosis did not significantly increase the risk for mortality among patients with schizophrenia; however, among those without the disorder dementia increased the risk by 30%.

“This analysis reinforces the concept that the increasing numbers of older seriously mentally ill, particularly older patients with schizophrenia, will create a serious burden for our health system that will require the development of new integrated models of health care involving links between the health and mental health systems,” the researchers wrote.

Disclosure: The study was supported by the National Institutes of Health (R24 MH080827 and R01 AG031222).