Indian J Psychiatry. 2025 Apr;67(4):391-398. doi: 10.4103/indianjpsychiatry.indianjpsychiatry_360_24. Epub 2025 Apr 15.
ABSTRACT
BACKGROUND: The Older adults with serious mental illness (OASMI) have a shorter life expectancy than the general population. Comorbidities are mainly responsible for this "mortality gap." India lacks field studies on comorbidities among the OASMI.
AIM: We aimed to determine the prevalence of self-reported medical comorbidities and associated factors among the OASMI in Kerala living in the community.
MATERIALS AND METHODS: The present study is a part of the Support system Evaluation of Neuropsychiatric Illness in Old age (SENIOR) research project. SENIOR used a cross-sectional study design, among OASMI participants identified through multistage cluster sampling from three districts in Kerala. For data collection trained research fellows conducted participant interviews at the participant households. The analysis of self-reported comorbidities for this paper was a secondary analysis derived from the primary data of the SENIOR study.
RESULTS: More than half (53.98%) of the 917 OASMI participants self-reported at least one medical comorbidity, with hypertension (32.2%) and diabetes (25.1%) being the most common. Reported comorbidity prevalence was lower, among those without partners (P < 0.011) or caregivers (P < 0.025); those not receiving psychiatric treatment (P < 0.011); those not covered by health insurance (P < 0.001); and those who did not have regular income (mostly through pension) (P < 0.039). The self-reported comorbidity prevalence among OASMI in our study was lower than the self-reported comorbidity prevalence among the general older adult (OA) population of Kerala in Longitudinal Ageing Study in India (LASI) (2017-2018).
CONCLUSION: The lower prevalence of self-reported comorbidity in our study indicates that comorbidities among the OASMI often go undetected. To address this issue, we propose that their contact with the healthcare system/provider must be utilized for comorbidities screening, and awareness on this created among all stakeholders. Implementing targeted screening for high-risk OASMI groups identified in our study can help narrow their mortality gap.
PMID:40371240 | PMC:PMC12073961 | DOI:10.4103/indianjpsychiatry.indianjpsychiatry_360_24