Abstract
Clinicians treating older adults should do multi-morbidity and individualized patient-centered assessment by a multidisciplinary collaborative team, including the patient’s individual health history, standardized rating scales, and laboratory workup. This assessment allows for a multi-morbidity patient-centered individualized treatment plan which takes into account both the old age patient’s physical and mental health and aims for the same values as the assessment, namely, a patient-centered, population-focused, and measurement-guided medical treatment. This chapter describes the two critical elements of this approach to geriatric psychiatry: (1) Establishing a correct diagnosis by way of targeted foundational aspects of the diagnostic interview, rating scales, and the laboratory workup of older adults and (2) Utilization of evidence-based collaborative care models for the elderly, with a description of the need for collaborative care models in the elderly, the necessary elements, the team structure, the evidence-based models in the elderly, and the limitations of the current state of collaborative care.
References
Adams, P. F., Kirzinger, W. K., & Martinez, M. E. (2012). Summary health statistics for the U.S. population: National health interview survey, 2011. Vital and Health Statistics. Series 10, (255), 1–110.
Alexopoulos, G. S., Abrams, R. C., Young, R. C., & Shamoian, C. A. (1988). Cornell scale for depression in dementia. Biological Psychiatry, 23(3), 271–284.
American Psychiatric Association/Academy of Psychosomatic Medicine. (2016). Dissemination of integrated care within adult primary care settings: The collaborative care model. https://www.psychiatry.org/File%20Library/Psychiatrists/Practice/Professional-Topics/Integrated-Care/APA-APM-Dissemination-Integrated-Care-Report.pdf
Andreas, S., Schulz, H., Volkert, J., Dehoust, M., Sehner, S., Suling, A., … & Härter, M. (2017). Prevalence of mental disorders in elderly people: The European MentDis_ICF65+ study. The British Journal of Psychiatry, 210(2), 125–131.
Barnett, K., Mercer, S. W., Norbury, M., Watt, G., Wyke, S., & Guthrie, B. (2012). Epidemiology of multimorbidity and implications for health care, research, and medical education: A cross-sectional study. Lancet, 380, 37–43.
Bartels, S. J., DiMilia, P. R., Fortuna, K. L., & Naslund, J. A. (2020). Integrated care for older adults with serious mental illness and medical comorbidity: Evidence-based models and future research directions. Clinics in Geriatric Medicine, 36, 341–352.
Beck, A. T., Ward, C., Mendelson, M., Mock, J., & Erbaugh, J. (1961). Beck depression inventory (BDI). Archives of General Psychiatry, 4(6), 561–571.
Blessed, G., Tomlinson, B. E., & Roth, M. (1968). The association between quantitative measures of dementia and of senile change in the cerebral grey matter of elderly subjects. The British Journal of Psychiatry, 114(512), 797–811.
Borges, M. K., Voshaar, R. C. O., Romanini, C. F. V., Oliveira, F. M., Lima, N. A., Petrella, M., Costa, D. L., Martinelli, J. E., Mingardi, S. V. B., Siqueira, A., Biela, M., Collard, R., & Aprahamian, I. (2021). Could frailty be an explanatory factor of the association between depression and other geriatric syndromes in later life? Clinical Gerontologist, 44, 143–153.
Callaghan, P., Eales, S., Coates, T., & Bowers, L. (2003). A review of research on the structure, process and outcome of liaison mental health services. Journal of Psychiatric and Mental Health Nursing, 10, 155–165.
Canuto, A., Gkinis, G., DiGiorgio, S., Arpone, F., Herrmann, F. R., & Weber, K. (2015). Agreement between physicians and liaison psychiatrists on depression in old age patients of a general hospital: Influence of symptom severity, age and personality. Aging & Mental Health, 20(10), 1092.
Cerra, F. B., & Brandt, B. F. (2015). Chapter 9 – The growing integration of health professions education. In S. A. Wartman (Ed.), The transformation of academic health centers (pp. 81–90). Academic.
Chang, A. Y., Gómez-Olivé, F. X., Payne, C., Rohr, J. K., Manne-Goehler, J., Wade, A. N., Wagner, R. G., Montana, L., Tollman, S., & Salomon, J. A. (2019). Chronic multimorbidity among older adults in rural South Africa. BMJ Global Health, 4, e001386.
Chua, X. Y., Ha, N. H. L., Cheong, C. Y., Wee, S. L., & Yap, P. L. K. (2019). The changing profile of patients in a geriatric medicine led memory clinic over 12 years. The Journal of Nutrition, Health & Aging, 23, 310–315.
Clancy, U., Brown, M., Alio, Z., Wardle, K., & Pendleton, N. (2018). Older people with hip fracture transferred to intermediate care: Outcomes in an integrated health and social care model. Future Healthcare Journal, 5, 58–63.
Cohen-Mansfield, J., Marx, M. S., & Rosenthal, A. S. (1989). A description of agitation in a nursing home. Journal of Gerontology, 44(3), M77–M84.
Costanza, A., Baertschi, M., Weber, K., & Canuto, A. (2015). Maladies neurologiques et suicide: de la neurobiologie au manque d’espoir [Neurological diseases and suicide: From neurobiology to hopelessness]. Revue Médicale Suisse, 11, 402–405.
Costanza, A., Amerio, A., Radomska, M., Ambrosetti, J., Di Marco, S., Prelati, M., Aguglia, A., Serafini, G., Amore, M., Bondolfi, G., Michaud, L., & Pompili, M. (2020a). Suicidality assessment of the elderly with physical illness in the emergency department. Frontiers in Psychiatry, 11, 558974.
Costanza, A., Amerio, A., Aguglia, A., Escelsior, A., Serafini, G., Berardelli, I., Pompili, M., & Amore, M. (2020b). When sick brain and hopelessness meet: Some aspects of suicidality in the neurological patient. CNS & Neurological Disorders Drug Targets, 19, 257–263.
Cummings, J. L., Mega, M., Gray, K., Rosenberg-Thompson, S., Carusi, D. A., & Gornbein, J. (1994). The neuropsychiatric inventory: Comprehensive assessment of psychopathology in dementia. Neurology, 44(12), 2308–2308.
de Bruin, S. R., Versnel, N., Lemmens, L. C., Molema, C. C. M., Schellevis, F. G., Nijpels, G., & Baan, C. A. (2012). Comprehensive care programs for patients with multiple chronic conditions: A systematic literature review. Health Policy, 107, 108–145.
Draper, B. (2000). The effectiveness of old age psychiatry services. International Journal of Geriatric Psychiatry, 15, 687–703.
Ely, E. W., Margolin, R., Francis, J., May, L., Truman, B., Dittus, R., … & Inouye, S. K. (2001). Evaluation of delirium in critically ill patients: Validation of the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU). Critical Care Medicine, 29(7), 1370–1379.
Fabbri, E., An, Y., Zoli, M., Simonsick, E. M., Guralnik, J. M., Bandinelli, S., Boyd, C. M., & Ferrucci, L. (2015). Aging and the burden of multimorbidity: Associations with inflammatory and anabolic hormonal biomarkers. The Journals of Gerontology. Series A, Biological Sciences and Medical Sciences, 70, 63–70.
Folstein, M. F., Folstein, S. E., & McHugh, P. R. (1975). “Mini-mental state”: A practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12(3), 189–198.
Franse, C. B., van Grieken, A., Alhambra-Borrás, T., Valía-Cotanda, E., van Staveren, R., Rentoumis, T., Markaki, A., Bilajac, L., Marchesi, V. V., Rukavina, T., Verma, A., Williams, G., Koppelaar, E., Martijn, R., Voorham, A. J. J., Mattace Raso, F., Garcés-Ferrer, J., & Raat, H. (2018). The effectiveness of a coordinated preventive care approach for healthy ageing (UHCE) among older persons in five European cities: A pre-post controlled trial. International Journal of Nursing Studies, 88, 153–162.
Frost, R., Bauernfreund, Y., & Walters, K. (2019). Non-pharmacological interventions for depression/anxiety in older adults with physical comorbidities affecting functioning: Systematic review and meta-analysis. International Psychogeriatrics, 31, 1121–1136.
Gowers, S. G., Harrington, R. C., Whitton, A., Lelliott, P., Beevor, A., Wing, J., & Jezzard, R. (1999). Brief scale for measuring the outcomes of emotional and behavioural disorders in children. The British Journal of Psychiatry, 174(5), 413–416.
Hamilton, M. (1960). A rating scale for depression. Journal of Neurology, Neurosurgery, and Psychiatry, 23(1), 56.
Inouye, S. K., van Dyck, C. H., Alessi, C. A., Balkin, S., Siegal, A. P., & Horwitz, R. I. (1990). Clarifying confusion: The confusion assessment method: A new method for detection of delirium. Annals of Internal Medicine, 113(12), 941–948.
Kanasi, E., Ayilavarapu, S., & Jones, J. (2016). The aging population: Demographics and the biology of aging. Periodontology 2000, 72, 13–18.
Karlin, B. E., & Fuller, J. D. (2007). Meeting the mental health needs of older adults. Geriatrics, 62, 26–35.
Kim, Y. S., Lee, J., Moon, Y., Kim, K. J., Lee, K., Choi, J., & Han, S. H. (2018). Unmet healthcare needs of elderly people in Korea. BMC Geriatrics, 18, 98.
Li, L. W., Xue, J., Conwell, Y., Yang, Q., & Chen, S. (2020). Implementing collaborative care for older people with comorbid hypertension and depression in rural China. International Psychogeriatrics, 32, 1457–1465.
Looman, W. M., Fabbricotti, I. N., de Kuyper, R., & Huijsman, R. (2016). The effects of a pro-active integrated care intervention for frail community-dwelling older people: A quasi-experimental study with the GP-practice as single entry point. BMC Geriatrics, 16, 43.
Mas, M., Santaeugènia, S. J., Tarazona-Santabalbina, F. J., Gámez, S., & Inzitari, M. (2018). Effectiveness of a hospital-at-home integrated care program as alternative resource for medical crises care in older adults with complex chronic conditions. Journal of the American Medical Directors Association, 19, 860–863.
McDonald, S. R., Heflin, M. T., Whitson, H. E., Dalton, T. O., Lidsky, M. E., Liu, P., Poer, C. M., Sloane, R., Thacker, J. K., White, H. K., Yanamadala, M., & Lagoo-Deenadayalan, S. A. (2018). Association of integrated care coordination with postsurgical outcomes in high-risk older adults: The Perioperative Optimization of Senior Health (POSH) Initiative. JAMA Surgery, 153, 454–462.
McMaster Health Forum. (2017). Identifying and assessing core components of collaborative-care models for mental and physical health conditions. https://www.mcmasterforum.org/docs/default-source/product-documents/rapid-responses/identifying-and-assessing-core-components-of-collaborative-care-models.pdf?sfvrsn=2
Montgomery, S. A., & Åsberg, M. A. R. I. E. (1979). A new depression scale designed to be sensitive to change. The British Journal of Psychiatry, 134(4), 382–389.
Mukaetova-Ladinska, E. B. (2016). Current and future perspectives of liaison psychiatry services: Relevance for older people’s care. Geriatrics (Basel), 1, 7.
Nasreddine, Z. S., Phillips, N. A., Bédirian, V., Charbonneau, S., Whitehead, V., Collin, I., … & Chertkow, H. (2005). The Montreal Cognitive Assessment, MoCA: A brief screening tool for mild cognitive impairment. Journal of the American Geriatrics Society, 53(4), 695–699.
National Institute of Health, National Institute of Deafness and Other Communication Disorders. (2018) Hearing Loss and Older Adults. https://www.nidcd.nih.gov/health/hearing-loss-older-adults
Pisani, M. A., Murphy, T. E., Van Ness, P. H., Araujo, K. L., & Inouye, S. K. (2007). Characteristics associated with delirium in older patients in a medical intensive care unit. Archives of Internal Medicine, 167(15), 1629–1634.
Platzer, E., Singler, K., Dovjak, P., Wirnsberger, G., Perl, A., Lindner, S., Liew, A., & Roller-Wirnsberger, R. E. (2020). Evidence of inter-professional and multi-professional interventions for geriatric patients: A systematic review. International Journal of Integrated Care, 20, 6.
Quillen, D. A. (1999). Common causes of vision loss in elderly patients. American Family Physician, 60(1), 99–108.
Sheikh, J. I., & Yesavage, J. A. (1986). Geriatric Depression Scale (GDS): Recent evidence and development of a shorter version. Clinical Gerontologist: The Journal of Aging and Mental Health, 5, 165–173.
Shulman, K. I., Shedletsky, R., & Silver, I. L. (1986). The challenge of time: Clock-drawing and cognitive function in the elderly. International Journal of Geriatric Psychiatry, 1(2), 135–140.
Singh, I., Fernando, P., Griffin, J., Edwards, C., Williamson, K., & Chance, P. (2016). Clinical outcome and predictors of adverse events of an enhanced older adult psychiatric liaison service: Rapid Assessment Interface and Discharge (Newport). Clinical Interventions in Aging, 12, 29–36.
Spoorenberg, S. L., Reijneveld, S. A., Uittenbroek, R. J., Kremer, H. P., & Wynia, K. (2019). Health-related problems and changes after 1 year as assessed with the geriatric ICF core set (GeriatrICS) in community-living older adults who are frail receiving person-centered and integrated care from embrace. Archives of Physical Medicine and Rehabilitation, 100, 2334–2345.
Tan, S. S., Fierloos, I. N., Zhang, X., Koppelaar, E., Alhambra-Borras, T., Rentoumis, T., Williams, G., Rukavina, T., van Staveren, R., Garces-Ferrer, J., Franse, C. B., & Raat, H. (2020). The association between loneliness and health related quality of life (HR-QoL) among community-dwelling older citizens. International Journal of Environmental Research and Public Health, 17, 600.
Thacker, S., Skelton, M., & Harwood, R. (2017). Psychiatry and the geriatric syndromes – creating constructive interfaces. BJPsych Bulletin, 41, 71–75.
Uhm, K. E., Oh-Park, M., Kim, Y. S., Park, J. M., Choi, J., Moon, Y., Han, S. H., Hwang, J. H., Lee, K. S., & Lee, J. (2020). Applicability of the 48/6 model of care as a health screening tool, and its association with mobility in community-dwelling older adults. Journal of Korean Medical Science, 35, e43.
Walker, J., Burke, K., Toynbee, M., van Niekerk, M., Frost, C., Magill, N., Walker, S., Sculpher, M., White, I. R., & Sharpe, M. (2019). The HOME Study: Study protocol for a randomised controlled trial comparing the addition of Proactive Psychological Medicine to usual care, with usual care alone, on the time spent in hospital by older acute hospital inpatients. Trials, 20, 483.
Wang, L., Si, L., Cocker, F., Palmer, A. J., & Sanderson, K. (2018). A systematic review of cost-of-illness studies of multimorbidity. Applied Health Economics and Health Policy, 16, 15–29.
Wittchen, H. U., Strehle, J., Gerschler, A., Volkert, J., Dehoust, M. C., Sehner, S., … & Andreas, S. (2015). Measuring symptoms and diagnosing mental disorders in the elderly community: The test–retest reliability of the CIDI65+. International Journal of Methods in Psychiatric Research, 24(2), 116–129.
Wolff, J. L., Feder, J., & Schulz, R. (2016). Supporting family caregivers of older Americans. New England Journal of Medicine, 375(26), 2513–2515.
World Health Organization. (2015a). World report on ageing and health. https://www.who.int/ageing/events/world-report-2015-launch/en/
World Health Organization. (2015b). WHO global strategy on integrated people-centred health services 2016–2026. https://www.who.int/servicedeliverysafety/areas/people-centred-care/global-strategy/en/
World Health Organization. (2016). Framework on integrated people-centred health services. https://www.who.int/servicedeliverysafety/areas/people-centred-care/framework/en/
Yen, T. Y., Beriwal, N., Kaur, P., Ravat, V., & Patel, R. S. (2020). Medical comorbidities and association with mortality risk in Alzheimer’s disease: Population-based study of 132,405 geriatric inpatients. Cureus, 12, e8203.
Yesavage, J. A., Brink, T. L., Rose, T. L., Lum, O., Huang, V., Adey, M., & Leirer, V. O. (1982). Development and validation of a geriatric depression screening scale: A preliminary report. Journal of Psychiatric Research, 17(1), 37–49.
Zhu, T., Xue, J., & Chen, S. (2019). Social support and depression related to older adults’ hypertension control in rural China. The American Journal of Geriatric Psychiatry, 27, 1268–1276.
Zigmond, A. S., & Snaith, R. P. (1983). The hospital anxiety and depression scale. Acta Psychiatrica Scandinavica, 67(6), 361–370.
Zulman, D. M., Pal Chee, C., Wagner, T. H., Yoon, J., Cohen, D. M., Holmes, T. H., Ritchie, C., & Asch, S. M. (2015). Multimorbidity and healthcare utilisation among high-cost patients in the US Veterans Affairs Health Care System. BMJ Open, 5, e007771.
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Avari, J.N., Costanza, A., Weber, K., Canuto, A. (2023). Collaborative Care and Geriatric Psychiatry. In: Tasman, A., et al. Tasman’s Psychiatry. Springer, Cham. https://doi.org/10.1007/978-3-030-42825-9_57-1
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