[Somatic risks in elderly people with severe psychiatric illnesses]

Abstract

Background: Aged patients with severe mental illness (SMI) suffer from a high risk for functional impairment and a high load of somatic comorbidities. Until now, there has been a lack of systematic studies on this patient population in later life. This review summarizes the most significant somatic comorbidities and discusses the consequences for the medical care of this elderly group of patients.

Methods: A selective narrative review based on PubMed research and observations in clinical practice.

Results: Life expectancy is shortened by approximately 10 years in patients with SMI. The main reasons are somatic comorbidities, particularly lung and respiratory tract disorders, metabolic syndrome with its subsequent cardiovascular complications, in addition to osteoporosis and fractures with a complicated clinical course. Although life expectancy is shortened, the number of geriatric patients with SMI is increasing and requires special attention to be given to out-patient psychosocial care, self-management of somatic diseases, and to age-appropriate continuation of psychiatric treatment.

Conclusion: The life expectancy of patients with SMI is reduced because of their typically somatic comorbidity, but they are reaching increasingly advanced ages as a consequence of improved treatment possibilities. They often require special attention in their diagnostic work-up and support in the management of their treatment. Collaborative care linking medical geriatric and geronto-psychiatric treatment facilities is helpful in the the interdisciplinary therapy required.

Keywords: Comorbidity; Geriatric patients; Life expectancy; Psychosocial nursing; Severe mental illness.