Symptoms of mental health and psychotropic drug use among old people in geriatric care, changes between 1982 and 2000.

Background: Some major changes have occurred in the care of older people in institutions providing geriatric care from a few decades ago to today. How these changes regarding organization, diagnosis and pharmacological treatment, have affected the mental health of the population in general remains unclear.

Method: The prevalence of symptoms of mental health in two comparable cross-sectional surveys from 1982 and 2000 were studied. The study population consisted of all the people aged 65 years or older living in geriatric care units in the county of Västerbotten, in northern Sweden. Multivariate regression was used to correct for the effect of change in demographic structure.

Results: Six out of 14 symptoms showed a significant decrease, correcting for demographical changes. These were, expressed as descriptions of behaviours, Sad (OR 0.72), Crying (OR 0.67), Fearful (OR 0.73), Disturbed and restless (OR 0.84), Lacking initiative (OR 0.67) and Does not cooperate (OR 0.67).Two symptoms showed a significant increase, Overactive/manic (OR 1.44) and Hallucinates visually (OR 1.27). The use of antidepressants had increased from 6.3% 1982 to 39.9% 2000. The use of minor tranquillizers had increased from 13.2% to 39.2% and the prevalence of antipsychotic use had decreased from 25.1% to 20.5%.

Conclusion: This article clearly shows that the prevalence of several important symptoms and behaviours in a geriatric care population have decreased over the course of eighteen years, correcting for demographical changes. This might at least partly be accounted for by today's more widespread use of antidepressants and benzodiazepines.