Rates of Late-Life Mental Illness Appear to Vary More Than Expected Among Ethnic Groups

While research suggests that adults from ethnic minority groups may be less susceptible to depression and other mental illnesses than non-Latino white adults, much of this research has focused on younger—not older—people. Determining whether older adults from certain ethnic groups are at higher risk of depression and other mental health problems is increasingly important; older members of ethnic minority groups now make up the fastest growing segment of the senior population.

Fortunately, research by a team led by Daniel E. Jimenez, PhD of Dartmouth Medical School sheds new light on this important issue. In a study published in February’s Journal of the American Geriatrics Society, Dr. Jimenez and colleagues.¹ examined the lifetime and 12-month prevalence of Diagnostic and Statistical Manual of Mental Disorders, fourth edition psychiatric disorders among a representative sample of nearly 2400 community-dwelling adults age 60 or older. The researchers compared the incidence of the disorders in older Latinos, Asians, African Americans, and Afro-Caribbeans with the prevalence in non-Latino whites.

There were some surprises.

Some, but not all, of the researchers’ results were similar to findings from previous studies of younger adults. The researchers found, for example, that over their lifetimes, older non-Latino whites had higher rates of panic disorder, social phobia, and alcohol abuse and dependence than older Latino, Asian, African-American, and Afro-Caribbean adults. The researchers also found that rates of alcohol and drug problems were lower among Asians than non-Latino whites, and that older African Americans had lower lifetime rates of depression than non-Latino whites. These findings are in keeping with those of studies of adults in general.

However, other findings differed from those of earlier research. The researchers found, for example, that over their lifetimes, older Latinos were just as, if not more, likely to experience major depression, dysthymia, agoraphobia, generalized anxiety disorder, post-traumatic stress disorder, and drug dependence than non-Latino whites. In addition, older Latinos had higher rates of depression over the preceding 12 months than non-Latino whites, they found.

While previous studies of adults suggest that immigrants tend to run a lower risk of mental health problems than those born in the United States, Dr. Jimenez and colleagues found that this wasn’t always the case with older adults. Older Latinos who had immigrated to the United States had higher rates of dysthymia and anxiety over their lifetimes, and higher rates of anxiety over a 12-month period than U.S.–born Latinos. And older Asian immigrants had higher lifetime rates of anxiety than older Asians born in the United States. Not only immigrant status, but also age at time of immigration seemed to affect risks of mental health problems in later life, the researchers found, which was consistent with the findings from Alegria et al² in 2007.

All told, the new research findings suggest that in later life, rates of mental health problems among ethnic groups and between immigrants and native-born older adults are more varied than previous studies suggest. That’s important to keep in mind, particularly with our increasingly diverse older population.

References

1. Jimenez DE, Alegría M, Chen CN, et al. Prevalence of psychiatric illnesses in older ethnic minority adults. J Am Geriatr Soc 2010;58(2):256-264.

2. Alegria M, Sribney W, Woo M, et al. Looking beyond nativity: The relation of age of immigration, length of residence, and birth cohorts to the risk of onset of psychiatric disorders for Latinos.Res Hum Dev2007;4:19-47.