A new study reveals, senior citizens in America, make fewer visits to psychiatrists than younger adults, but receive more than twice the prescriptions for mental health medications.
This is the first study to compare mental health treatment in patients aged 18 – 64 years against mental health treatment of seniors (adults over age 65). The authors of the study took data from out-patient visits across the country, and also U.S. census data as the primary source for their study.
The study shows that clinic visits related to antidepressant drug use among older adults was 62 visits annually per 100 people. This was nearly double the rates of such visits by younger adults – 36 visits annually per 100 people.
The results were similar for anti-anxiety drug use – 63 visits annually per 100 people in older adults versus 29 visits annually per 100 people.
In contrast, the psychiatrist visits are 6.3 visits annually per 100 older adults as against 12 visits annually per 100 younger adults.
The results of the study, published in the Journal of the American Geriatrics Society, raise two important questions: Are seniors at risk of problems caused by using multiple medications? and Do primary care doctors need more support to care for older people with depression, anxiety and other mental conditions?
According to Donovan Maust, the geriatric psychiatrist who led the study, health officials should be looking at seniors resorting to polypharmacy, or taking multiple drugs at once.
The findings of the study suggest that seniors rely on psychotropic medication far more than younger adults do. In many cases, especially for milder depression and anxiety, the safer treatment for seniors might be more therapy-oriented, but very few older adults receive this sort of care.
Another reason why multiple-medication is of a bigger concern in older adults, is because the risk/benefit balance shifts more towards risk as people grow older – as they are more likely to experience side effects. For example, anxiety drugs may be relatively safe for younger adults, but carry a higher risk of car accidents, falls, fractures and worsening of thinking ability or memory in seniors.
Antidepressants can interact with other medication such as blood thinners and painkillers to raise blood pressure in older adults. But as youngsters do not usually take that kind of medication, antidepressants are a safer option for them.
“We need to pay special attention to polypharmacy, or multiple drugs taken at once, when prescribing psychotropic drugs in this population, because so many older adults are already on multiple medications,” said Maust.
While it’s still true that there are older adults who are not getting treated for mental health concerns, the data suggests that we also need to be mindful of the possibility of overtreatment, especially given the changing balance of risk and benefit as patients age.