title: Chronic physical conditions in older adults with mental illness and/ or substance use disorders.
abstract: OBJECTIVE
  To examine the association between mental illness and chronic physical conditions in older adults and investigate whether co-occurring substance use disorders (SUDs) are associated with greater risk of chronic physical conditions beyond mental illness alone.
  
  
  METHODS
  A retrospective cross-sectional study.
  
  
  METHODS
  Medicare and Medicaid programs in Massachusetts.
  
  
  METHODS
  Massachusetts Medicare and Medicaid members aged 65 and older as of January 1, 2005 (N = 679,182).
  
  
  METHODS
  Diagnoses recorded on Medicare and Medicaid claims were used to identify mental illness, SUDs, and 15 selected chronic physical conditions.
  
  
  RESULTS
  Community-dwelling older adults with mental illness or SUDs had higher adjusted risk for 14 of the 15 selected chronic physical conditions than those without these disorders; the only exception was eye diseases. Moreover, those with co-occurring SUDs and mental illness had the highest adjusted risk for 11 of these chronic conditions. For residents of long-term care facilities, mental illness and SUDs were only moderately associated with the risk of chronic physical conditions.
  
  
  CONCLUSIONS
  Community-dwelling older adults with mental illness or SUDs, particularly when they co-occurred, had substantially greater medical comorbidity than those without these disorders. For residents of long-term care facilities, the generally uniformly high medical comorbidity may have moderated this relationship, although their high prevalence of mental illness and SUDs signified greater healthcare needs. These findings strongly suggest the imminent need for integrating general medical care, mental health services, and addiction health services for older adults with mental illness or SUDs.
authors.affiliation: Center for Health Policy and Research, University of Massachusetts Medical School, Shrewsbury, Massachusetts 01545, USA. wen.lin@umassmed.edu
authors.forename: Wen-Chieh
authors.initials: WC
authors.lastname: Lin
authors.forename: Jianying
authors.initials: J
authors.lastname: Zhang
authors.forename: Gary Y
authors.initials: GY
authors.lastname: Leung
authors.forename: Robin E
authors.initials: RE
authors.lastname: Clark
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease / Q000453:epidemiology* / Q000523:psychology; D015897:Comorbidity; D003430:Cross-Sectional Studies; D005260:Female; D006306:Health Surveys; D006801:Humans; D008297:Male; D008404:Massachusetts; D008484:Medicaid / Q000706:statistics & numerical data; D006278:Medicare / Q000706:statistics & numerical data; D001523:Mental Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D012189:Retrospective Studies; D012306:Risk; D019966:Substance-Related Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D014481:United States