• Hugh C Hendrie, Donald Lindgren, Donald P Hay, Kathleen A Lane, Sujuan Gao, Christianna Purnell, Stephanie Munger, Faye Smith, Jeanne Dickens, Malaz A Boustani, and Christopher M Callahan.
• Indiana University School of Medicine, Indianapolis; Indiana University Center for Aging Research, Indianapolis; Regenstrief Institute Inc., Indianapolis; Indiana University Department of Psychiatry, Indianapolis. Electronic address: hhendri@iupui.edu.
• Am J Geriatr Psychiatry. 2013 Dec 1;21(12):1267-76.

ObjectivesPatients with serious mental illness are living longer. Yet, there remain few studies that focus on healthcare utilization and its relationship with comorbidities in these elderly mentally ill patients.DesignComparative study. Information on demographics, comorbidities, and healthcare utilization was taken from an electronic medical record system.SettingWishard Health Services senior care and community mental health clinics.ParticipantsPatients age 65 years and older-255 patients with serious mental illness (schizophrenia, major recurrent depression, and bipolar illness) attending a mental health clinic and a representative sample of 533 nondemented patients without serious mental illness attending primary care clinics.ResultsPatients having serious mental illness had significantly higher rates of medical emergency department visits (p = 0.0027) and significantly longer lengths of medical hospitalizations (p <0.0001) than did the primary care control group. The frequency of medical comorbidities such as diabetes, coronary artery disease, congestive heart failure, chronic obstructive pulmonary disease, thyroid disease, and cancer was not significantly different between the groups. Hypertension was lower in the mentally ill group (p <0.0001). Reported falls (p <0.0001), diagnoses of substance abuse (p = 0.02), and alcoholism (p = 0.0016) were higher in the seriously mentally ill. The differences in healthcare utilization between the groups remained significant after adjusting for comorbidity levels, lifestyle factors, and attending primary care.ConclusionsOur findings of higher rates of emergency care, longer hospitalizations, and increased frequency of falls, substance abuse, and alcoholism suggest that seriously mentally ill older adults remain a vulnerable population requiring an integrated model of healthcare.Copyright © 2013 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.

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