Psychiatric status among the homebound elderly: an epidemiologic perspective.
OBJECTIVE
To compare the prevalence of specific psychiatric disorders in the homebound elderly to other elders, controlling for demographic, physical health, and socio-economic factors.


METHODS
Survey.


METHODS
Epidemiologic Catchment Area (ECA) project in New Haven, CT.


METHODS
2,553 non-institutionalized elders representing the total elderly population of the greater New Haven area.


METHODS
None


METHODS
Homebound status determined by self-report; psychiatric status according to DSM III by the Diagnostic Interview Schedule (DIS); cognitive status by Mini-Mental Status Examination.


RESULTS
Cognitive impairment (21.8% vs 11.0%, P less than 0.001), depression (2.3% vs 0.7%, P less than 0.01), dysthymia (3.9% vs 1.7%, P less than 0.01), and anxiety disorders (2.2% vs 0.4%, P less than 0.001) were each at least twice as prevalent among elders confined to a bed or chair as among non-homebound elders. Most of this increase was consistent with the poorer physical health status of the homebound; after controlling for health status, only dysthymia (Odds ratio = 2.1, P less than 0.01) was significantly more prevalent among elders confined to a bed or chair.


CONCLUSIONS
The higher prevalence of disorders among the homebound support recommendations that psychiatric assessments become routine in primary care examinations of homebound elders and that the availability of preventive and therapeutic psychiatric services to the homebound increase.
Bruce
M L
ML
Department of Epidemiology and Public Health, Yale University.
McNamara
R
R
D000368:Aged; D000437:Alcoholism / Q000175:diagnosis / Q000453:epidemiology; D001007:Anxiety / Q000175:diagnosis / Q000453:epidemiology; D002908:Chronic Disease; D003863:Depression / Q000175:diagnosis / Q000453:epidemiology; D003866:Depressive Disorder / Q000175:diagnosis / Q000453:epidemiology; D006233:Persons with Disabilities; D005260:Female; D006304:Health Status; D006798:Housing; D006801:Humans; D007406:Interview, Psychological; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000453:epidemiology*; D011569:Psychiatric Status Rating Scales; D012494:Sampling Studies; D012959:Socioeconomic Factors