title: Perceived Risk of Mental Health Problems in Primary Care.
abstract: In the face of limited resources and an aging population with increasingly care needs, healthcare systems must identify community-dwelling older adults with mental health problems at higher risk of adverse outcomes such as institutionalization, hospitalization and death, in order to deliver timely and efficient care. The objectives of this study were to assess the prevalence of mental health concerns and the associated perceived risk of adverse outcomes in a large sample of older patients in primary care (PC). We trained general practitioners and nurses to use the Risk Instrument for Screening in the Community to rank perceived risk of mental health concerns (including neurocognitive and mood disorders) from 1 (mild) to 3 (severe). The mean age of the 4499 people assessed was 76.3 years (SD = 7.3) and 2645 (58.8%) were female. According to the PC team 1616 (35.9%) were perceived to have mental health concerns of whom 847 (52.4%) were mild, 559 (34.6%) were moderate and 210 (13%) were severe. Patients with mental health concerns had higher odds of perceived risk of adverse outcomes (OR = 2.22, 95% CI 1.83-2.69 for institutionalization; OR = 1.66, 95% CI 1.41-1.94 for hospitalization; OR = 1.69, 95% CI 1.42-2.01 for death). These results suggest a high prevalence of mental health concerns among older adults and supports the need for early identification of patients at high-risk of adverse healthcare outcomes.
authors.affiliation: Research and Education Unit on Ageing, Institute of Biomedical Sciences Abel Salazar, University of Porto Porto, Portugal.
authors.forename: Constança
authors.initials: C
authors.lastname: Paúl
authors.affiliation: Research and Education Unit on Ageing, Institute of Biomedical Sciences Abel Salazar, University of Porto Porto, Portugal.
authors.forename: Laetitia
authors.initials: L
authors.lastname: Teixeira
authors.affiliation: Research and Education Unit on Ageing, Institute of Biomedical Sciences Abel Salazar, University of Porto Porto, Portugal.
authors.forename: Maria João
authors.initials: MJ
authors.lastname: Azevedo
authors.affiliation: Research and Education Unit on Ageing, Institute of Biomedical Sciences Abel Salazar, University of Porto Porto, Portugal.
authors.forename: Sara
authors.initials: S
authors.lastname: Alves
authors.affiliation: Research and Education Unit on Ageing, Institute of Biomedical Sciences Abel Salazar, University of Porto Porto, Portugal.
authors.forename: Mafalda
authors.initials: M
authors.lastname: Duarte
authors.affiliation: Centre for Gerontology and Rehabilitation, St Finbarrs Hospital - University College Cork Cork City, Ireland ; COLLaboration on AGEing, University College Cork, Cork, and NetwellCASALA - Dundalk Institute of Technology Dundalk, Ireland ; Health Research Board, Clinical Research Facility Galway, National University of Ireland Galway, Ireland.
authors.forename: Rónán
authors.initials: R
authors.lastname: O'Caoimh
authors.affiliation: Centre for Gerontology and Rehabilitation, St Finbarrs Hospital - University College Cork Cork City, Ireland ; COLLaboration on AGEing, University College Cork, Cork, and NetwellCASALA - Dundalk Institute of Technology Dundalk, Ireland.
authors.forename: William
authors.initials: W
authors.lastname: Molloy
keywords: RISC; mental health; old people; primary care; risk