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Factors associated with late-life psychosis in primary care older adults without a diagnosis of dementia

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Abstract

Purpose

The epidemiology of late-life psychosis (LLP) remains unclear comparatively to early-onset psychosis. The study aims to estimate the prevalence and incidence of LLP over a 3-year period and examine the correlates of LLP in community-living older adults aged ≥ 65 years recruited in primary care.

Methods

Study sample included N = 1481 primary care older adults participating in the Étude sur la Santé des Aînés (ESA)-Services study. Diagnoses were obtained from health administrative and self-reported data in the 3 years prior and following baseline interview. The prevalence and incidence of LLP (number of cases) were identified in the 3-year period following interview. Participants with dementia or psychosis related to dementia were excluded. Logistic regressions were used to ascertain the correlates of LLP as function of various individual and health system factors.

Results

The 3-year prevalence and incidence of LLP was 4.7% (95% CI = 3.64–5.81) and 2.8% (95% CI = 1.99–3.68), respectively. Factors associated with both prevalent and incident LLP included functional status, number of physical diseases, hospitalizations, continuity of care and physical activity. Older age and the presence of suicidal ideation were associated with incident LLP, while higher education, a depressive disorder and a history of sexual assault were associated with persistent cases.

Conclusions

Results highlight the importance of LLP in primary care older adult patients without dementia. Health system factors were consistent determinants of prevalent and incident LLP, suggesting the need for better continuity of care in at-risk primary care older adults.

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Availability of data and materials

The authors are not legally authorized to share or publicly publish linked survey and health administrative data due to privacy or ethical restrictions related to the use of administrative provincial health data. Participants were not requested to give informed consent for data sharing. The province of Québec’s ‘Commission d’Accès à l’Information’ gave approval to merge these datasets. Requests for access to the data should be addressed to the research ethics committee of the CISSS Montérégie-Centre.

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Acknowledgements

Dr. Djamal Berbiche for merging datasets and the preparation of study variables.

Funding

The ESA-Services study was in part funded by an FRQ-S (#16000, #22251) and a pilot project grant from the FRQ-S Quebec Network for Research on Aging. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Author information

Authors and Affiliations

  1. Centre de Recherche-CSIS, Faculté de Médecine et Sciences de la Santé, Université de Sherbrooke, Campus Longueuil, 150 Place Charles-Le Moyne, Longueuil, QC, J4K 0A8, Canada

    Helen-Maria Vasiliadis, Isabelle Pitrou & Catherine Lamoureux-Lamarche

  2. Department of Psychology, Université de Montréal, Centre de Recherche de l’Institut Universitaire de Gériatrie de Montréal CRIUGM, Montreal, QC, Canada

    Sébastien Grenier

  3. Centre de Recherche du CHUM, Université de Montréal, Montreal, QC, Canada

    Patrick Viet-Quoc Nguyen

  4. School of Psychology, Université Laval, CERVO Brain Research Centre, Quebec, QC, Canada

    Carol Hudon

Authors
  1. Helen-Maria Vasiliadis
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  2. Isabelle Pitrou
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  3. Catherine Lamoureux-Lamarche
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  4. Sébastien Grenier
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  5. Patrick Viet-Quoc Nguyen
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  6. Carol Hudon
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Contributions

HMV, SG, PVQN and CH planned the study. IP conducted the statistical analyses. HMV, IP and CLL wrote the first draft of the paper. All authors contributed to the interpretation of results and revised the manuscript.

Corresponding author

Correspondence to Helen-Maria Vasiliadis.

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Conflict of interest

On behalf of all authors, the corresponding author states that there is no conflict of interest.

Ethics approval

The present study was reviewed and approved by the ethics committee of the CISSS-Montérégie Centre and has, therefore, been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments.

Consent to participate

All participants gave written consent for their participation to the study and for the linkage of their health survey and administrative data.

Supplementary Information

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Supplementary file1 (DOCX 17 KB)

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Vasiliadis, HM., Pitrou, I., Lamoureux-Lamarche, C. et al. Factors associated with late-life psychosis in primary care older adults without a diagnosis of dementia. Soc Psychiatry Psychiatr Epidemiol 57, 505–518 (2022). https://doi.org/10.1007/s00127-021-02132-7

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  • DOI: https://doi.org/10.1007/s00127-021-02132-7

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