There is a growing interest in understanding the burden of poisonings among older adults, including their socio-economic distribution, their intent, and their association with psychological and physical conditions.
This study investigates the incidence of intentional and unintentional poisoning by medication, alcohol and illicit drugs among older adults and their association with psychiatric disorders.
We conducted a national register-based cohort study where individuals born from 1958 were followed up for episodes of hospitalization, consumption of medication, and eventual hospitalization or death by poisoning. For each substance under study, we compiled the percentages of poisoning and measured the association with hospitalization for psychiatric disorders (1 month prior to the index date). Crude and adjusted (for age, gender, marital status, and comorbidity and number of prescribed medications) odds ratios were estimated by logistic regression.
Altogether the cumulative incidence of intentional poisoning was by far higher than that of unintentional (51.6 vs 28.5 per 100 000 population) and higher for hospitalisation than fatal events. While intentional poisonings by medication were more common than those by alcohol or illicit drugs (21%, 9% and 3% of all poisonings), unintentional poisoning by medication and alcohol occur in similar proportions (15% and 14%). The association between hospitalization for psychiatric disorder was considerable in all instances. It peaked for intentional poisoning, where it was relatively comparable for any of the three substances studied and reduced but remaining significant after adjustment. The same applied for unintentional poisonings although the odds were lower and the effect of illicit drugs lost significance after adjustment.
Poisonings is an important public health issue among older community dwellings and mental health can be a challenge in attempts to prevent them from occurring. Early identification of people at risk in diverse settings and rapid intervention are crucial.
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