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Disease expectancy and incidence of mental illness among the aged

The problems of mental illnesses among the aged and their need for care have in recent decades grown considerably. The number mentally ill is reflected in the increase in demands for nursing care. This is not solely due to the rise in the number of old persons. The increase in number of the aged in mental hospitals, for instance, proportionately outstrips the increase in the number of old people (Hagnell, 1954). The prevalence of mental illness in a normal population was shown in a previous investigation (Hagnell, 1961) to be higher than the number of beds these patients occupy in hospitals and nursing homes implied. Our knowledge about the extent of the spread of mental illness in the higher age groups in the normal population, however, is limited. In 1947, Erik Essen-Moller, with three other psychiatrists, investigated all (99%) of the inhabitants in a limited area in south Sweden, Lundby (EssenMoller, 1956). There were 2550 persons, 443 of them being 60 years of age (17.4%). Each one was interviewed and described by the investigator. This was further complemented with information from various persons who knew the population well, from hospital records, and from doctors in open practice. In 1957, ten years after Essen-Moller’s study, I repeated it: I sought out all who in 1947 were registered in Lundby, whether they still lived there or had moved, and interviewed them with special regard to what had happened during the recent decade. I also obtained information from those who knew the proband well, from doctors, and from hospitals. 104 men and 119 women had died during the decade. Concerning these, I got information from those who were nearest to them, who had possibly nursed them through their last days. For a fuller detailed description of the method, see Essen-Moller, 1956 and Hagnell, 1966.