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Risk factors for the late‐onset psychoses: a systematic review of cohort studies
Author(s) -
Brunelle Sarah,
Cole Martin G.,
Elie Michel
Publication year - 2012
Publication title -
international journal of geriatric psychiatry
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.28
H-Index - 129
eISSN - 1099-1166
pISSN - 0885-6230
DOI - 10.1002/gps.2702
Subject(s) - psychosis , cohort , cohort study , psychiatry , risk factor , psychology , dementia , medicine , clinical psychology , disease
Background Psychoses with onset in late adulthood are challenging. Identifying those older patients at risk would be clinically important and would have research implications. Methods A computer search was performed to identify all cohort studies of risk factor(s) for psychotic symptoms or disorders with onset at 40 years or older. Experts were contacted and bibliographies were screened for additional references. Validity of located studies was assessed according to evidence‐based medicine criteria for risk factors studies. Data were extracted and tabulated for qualitative and quantitative analyses. Results Twelve articles were retrieved, corresponding to 11 studies of 32 potential risk factors. In the qualitative analysis, only the history of psychotic symptoms, cognitive problems, poor health status, visual impairment, and negative life events appeared to be significant risk factors of late‐onset psychosis. Older age, female gender, and hearing impairment were not associated with psychosis in older patients. Quantitative analysis was feasible with only one item, female gender, and confirmed the lack of associated risk with late‐onset psychosis. Conclusions Despite the methodological limitations of the studies included in this review, there is some evidence from cohort studies that history of psychotic symptoms, cognitive problems, poor physical health, visual impairment, and negative life events are risk factors for late‐onset psychosis. More long‐term follow‐up studies are needed to confirm these findings. Copyright © 2011 John Wiley & Sons, Ltd.