title: Mortality and causes of death in older patients with schizophrenia.
abstract: OBJECTIVE
  The aim of this study was to evaluate mortality and causes of death in older patients with schizophrenia in comparison with the general population. The mortality of patients experiencing relapse was also compared with those in remission.
  
  
  METHODS
  The study sample consists of patients (n = 9461) over 65 years by the first of January 1999, with schizophrenia or schizoaffective disorder (ICD-8, ICD-9: 295, ICD-10: F20, F25) as the main register diagnosis during the period 1969-1998. The sample was collected from nationwide registers in Finland and followed up between 1999 and 2008.
  
  
  RESULTS
  Overall Standard Mortality Ratio (SMR) of the older schizophrenia patients was 2.69 [95% confidence interval, 2.62-2.76]. For natural causes of death, overall SMR was 2.58 (2.51-2.65; n = 5301), and for unnatural causes of death, it was 11.04 (9.75-12.47; n = 262). The most common causes of death matched those in the general population. Of patients who died during follow-up, 31% (1709/5596) had at least one psychiatric hospitalization within 5 years before follow-up. The SMR for this group was higher (3.92; 3.73-4.11) than in those patients (2.37; 2.29-2.44) with no such treatment during that time.
  
  
  CONCLUSIONS
  All-cause mortality of older patients with schizophrenia was almost threefold that of general population. They died for similar reasons to the general population; however, deaths for unnatural causes were especially common (accidents and suicides). Those patients still experiencing relapses in older age have an increased risk of death compared with those with schizophrenia in remission.
authors.affiliation: Helsinki University Central Hospital, Department of Psychiatry, Finland. tiina.talaslahti@kolumbus.fi
authors.forename: Tiina
authors.initials: T
authors.lastname: Talaslahti
authors.forename: Hanna-Mari
authors.initials: HM
authors.lastname: Alanen
authors.forename: Helinä
authors.initials: H
authors.lastname: Hakko
authors.forename: Matti
authors.initials: M
authors.lastname: Isohanni
authors.forename: Unto
authors.initials: U
authors.lastname: Häkkinen
authors.forename: Esa
authors.initials: E
authors.lastname: Leinonen
mesh_terms: D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D002423:Cause of Death; D005260:Female; D005387:Finland / Q000453:epidemiology; D006801:Humans; D008297:Male; D012559:Schizophrenia / Q000401:mortality*; D017678:Sex Distribution