Hostname: page-component-586b7cd67f-dsjbd Total loading time: 0 Render date: 2024-11-22T07:42:05.812Z Has data issue: false hasContentIssue false
  • English
  • Français

Topical issues in old age psychiatry

Published online by Cambridge University Press:  13 June 2014

Sharon Foley  and
Aideen Freyne
Aideen Freyne
Affiliation:
Dept of Old Age Psychiatry, Carew House, St. Vincent's University Hospital, Elm Park, Dublin 4, Ireland
Get access Rights & Permissions [Opens in a new window]

Abstract

With advancements in medical science over past decades, our aging population has increased substantially. Census studies in 2001 showed that 429,100 of the population of the Republic of Ireland were aged 65yrs and older, making up 11.2% of the overall population. While the overall population of the Republic is expected to remain stable over the next ten years, the demographic projections for the elderly population is for significant growth: numbers of over 65yrs are expected to increase by nearly 108,000 people between 1996 - 2011, comprising over 14.1% of the overall population. In particular, our communities will contain a much higher proportion of octogenarians and nonagenarians: at present 21% of our over 65's are 80 yrs or older; by 2011, it is projected that this number will increase to 25%. In tandem, the prevalence of dementia will increase.

In 2000, it was estimated that 31,000 people suffered with dementia in the Republic of Ireland, and this figure is expected to increase by 5000 cases per year between 2001-2011. The ultimate outcome of this demographic shift, will be higher demands on medical services for older people, especially geriatric medicine and old age psychiatry. This paper will focus on two particular aspects of management which will increasingly impact on the work of old age psychiatrists – medicolegal issues and management issues in dementia.

Type
Educational Review
Information
Irish Journal of Psychological Medicine , Volume 22 , Issue 3 , September 2005 , pp. 103 - 106
Copyright
Copyright © Cambridge University Press 2005

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Irish Life Tables no. 13. Dublin: Central Statistics Office, 2001.Google Scholar
2.Fahey, T. Health service implications of population ageing in Ireland 1991-2011. Dublin: National Council for the Elderly.Google Scholar
3.National Council on Ageing and Older People: Demography. Ageing in Ireland Fact File No.1. 2001Google Scholar
4.O'Shea, E. The cost of caring for people with dementia and related cognitive impairment. Dublin: National Council on Ageing and Older People, 2000.Google Scholar
5.Enduring Powers of Attorney Regulations 1996. Statutory Instrument No. 196 of 1996.Google Scholar
6.Draft Mental Incapacity Bill. CN 5859-1. 2003.Google Scholar
7.Masterman-Lister V Brutton & Co. [2002] EWCA Civ 1889, paragraph 17.Google Scholar
8.The Law Reform Commission. Consultation paper on Law and the Elderly. Ireland 2003. LRC CP 23. Section 77(1).Google Scholar
9.Government of Ireland. Succession Act 1965. Dublin: Stationary Office, 1965.Google Scholar
10.A Report of the British Medical Association and the Law Society. Assessment of mental capacity – guidance for doctors and lawyers. BMA Professional Division Publications, 2nd ed, 2004; 36–7.Google Scholar
11.Rv. Bournewood Community and Mental Health NHS Trust, ex parte L (1998) 3 AIIER 289.Google Scholar
12.http://www.rcpsych.ac.uk/college/faculty/oap/Bournewoodfinalinterim.pdfGoogle Scholar
13.Wards of Court- An information Booklet. Dublin: Department of Justice, Equality and Law Reform, 1998.Google Scholar
14. In re a Ward of Court (withholding medical treatment) (no. 2) [1996] 2 IR 79.Google Scholar
15.Cohen, CA, Gold, DP, Shulman, KIet al.Factors determining the decision to institutionalise dementing individuals: a prospective study. Gerontolgist 1993; 33: 714–20.CrossRefGoogle ScholarPubMed
16.Wooltorton, E. Olanzepine (Zyprexa): increased incidence of cerebrovascular events in dementia trials. CMAJ 2004; 170: 1395.CrossRefGoogle Scholar
17.Wooltorton, E. Risperidone (Risperdal): increased rate of cerebrovascular ebents in dementia trials. CMAJ 2002; 167: 1269–70.Google ScholarPubMed
18.Ballard, C, Margallo-Lana, M, Juszczak, Eet al.Quetiapine an rivastigmine and cognitive decline in Alzheimer's disease: randomised double blind placebo controlled trial. BMJ 2005; 330: 874–83.CrossRefGoogle ScholarPubMed
19.http://www.imb.ie Important New Safety Information on Olanzepine 9/03/2004.Google Scholar
20.Gill, S, Rochon, P, Herrmann, N, Lee, PEet al.Atypical antipsychotic drugs and risk of ischaemic stroke: population based retrospective cohort study. BMJ 2005; 330: 445.CrossRefGoogle ScholarPubMed
21.Smith, DA, Beier, MT. Association between risperidone treatment and cerebrovascular adverse events: examining the evidence and postulating hypotheses for an underlying mechanism. J Am Med Dir Assoc. 2004; 5: 129–32.CrossRefGoogle ScholarPubMed
22.http://www.catie.unc.edu/alzheimers/Google Scholar
23.http://www.nice.org.uk/guidance on the use of donezepil, rivastigmine and galantamine for the treatment of Alzheimer's disease.Google Scholar
24. Cochrane Database Syst Rev. 2000; (4): CD 001190Google Scholar
25. Cochrane Database Syst Rev. 2003; (3):CD 001190Google Scholar
26.Kmietowicz, Z, NICE proposes to withdraw Alzheimer's drugs from NHS. BMJ 2005; 330: 495.Google ScholarPubMed
27. Royal College of Psychiatrists response to the proposal of the National Institute of Clinical Excellence (NICE) to withdraw treatment for Alzheimer's disease from the NHS – college strongly disagrees with the preliminary recommendations. http://www.rcpsych.ac.uk/press/prereleases/pr/pr-653.htm.Google Scholar
28.Fillit, H, Hill, J. The economic benefits of acetylcholinesterase inhibitors for patients with Alzheimer's disease and associated dementias. Alz Dis Assoc Disord. 2004 Apr-Jun; 18(1): 524–9.CrossRefGoogle ScholarPubMed
29.http://www.bmj.com Rapid Responses for Kmietowicz, 330 (7490): 495.Google Scholar