Metabolic syndrome rates in older patients with severe mental illness after five years of follow-up and the association with mortality.

OBJECTIVES: To establish the course of metabolic syndrome (MS) rates in older patients with severe mental illness (SMI) after 5-year follow-up and evaluate whether MS at baseline is associated with mortality or diabetes at follow-up. METHODS: Patients (>60 years of age) with SMI (N = 100) were included at a specialized mental health outpatient clinic. Metabolic parameters were collected from patients' medical files at baseline and after 5-year follow-up. RESULTS: Follow-up data were available of 98 patients (98%); nine patients had died. Parameters of MS were available of 76 patients; 34.2% were diagnosed with MS. This was not significantly different compared with baseline (46.1%). MS at baseline was not significantly associated with mortality or development of diabetes at follow-up. CONCLUSIONS: In older patients with SMI, the rates of MS may reach a plateau. Screening for MS in older patients treated at a specialized mental health outpatient clinic may generate attention for their somatic health and treatment for the components of MS that may in turn have a positive effect on their outcome. However, further research with larger sample sizes is needed in order to confirm these findings.

Screening for metabolic syndrome in older patients with severe mental illness.

OBJECTIVE: To evaluate metabolic screening of elderly patients with severe mental illness (SMI) in terms of newly detected metabolic abnormalities. METHODS: Prospective evaluation of the metabolic screening outcome data of 100 consecutive elderly outpatients with SMI, all with universal access to health services. We gathered data on previous diagnoses of hypertension, diabetes, and dyslipidemia and assessed metabolic syndrome parameters. The findings were compared with those from a group of 124 healthy elderly. RESULTS: In our patients with SMI (mean age: 69 years; 52% bipolar disorder, 48% schizophrenia), the frequency of metabolic syndrome was not higher compared with the healthy elderly. However, in 51% of the SMI sample, metabolic screening detected at least one metabolic abnormality in a patient with no prior history for that specific parameter. CONCLUSION: Implementing routine screening for metabolic syndrome in elderly patients with SMI may reveal substantial rates of previously undetected metabolic abnormalities.