title: Ranges of psychiatric morbidity in the old and the very old--results from the Berlin Aging Study (BASE).
abstract: The purpose of this study was to determine prevalence rates of psychiatric morbidity in the elderly, distinguishing different levels of psychiatric caseness as compared to the diagnoses of the DSM-III-R. In a cross-sectional population-based study in Berlin (West), Germany, 516 people aged 70 to 95+ were randomly selected from the obligatory city registry (1990-1993) and stratified by age and gender (N = 43 men and N = 43 women in each of six 5-year age groups). Psychiatric and physical examinations were carried out in an extensive standardized assessment. Distinct psychopathological syndromes occurred in 72.7% of the elderly (54.6% of the men, 79.1% of the women). A clinically defined psychiatric disorder was found in 49.4% of the elderly (95% confidence interval 43.9%- 54.9%; 36.4% of the men, 54.0% of the women). Excluding insomnia, the overall psychiatric morbidity was 40.4% (30.9% m, 43.8% w). Excluding clinical diagnoses that were not otherwise specified in the DSM-III-R, the overall prevalence of specified DSM-III-R diagnoses was 23.5% (16.3% m, 26.0% w). Excluding dementia, which is known to be age-related, the prevalence was 11.3% (8.5% m, 12.2% w) and no significant effect between the age groups was seen. A considerable proportion of clinically relevant psychiatric morbidity in the elderly does not meet the criteria of specified DSM-III-R diagnoses, although these cases are in need of care. The data show that the threshold and severity of caseness accounts for important differences when overall psychiatric morbidity is assessed.
authors.affiliation: Department of Psychiatry, Free University of Berlin, Germany.
authors.forename: T F
authors.initials: TF
authors.lastname: Wernicke
authors.forename: M
authors.initials: M
authors.lastname: Linden
authors.forename: R
authors.initials: R
authors.lastname: Gilberg
authors.forename: H
authors.initials: H
authors.lastname: Helmchen
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000502:physiology*; D002391:Catchment Area, Health; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis* / Q000453:epidemiology*; D015995:Prevalence; D011569:Psychiatric Status Rating Scales; D012720:Severity of Illness Index