Metabole screening bij oudere patiënten met een ernstige psychiatrische aandoening1

Diabetes, cardiovascular disease and metabolic syndrome are more prevalent in older patients with severe mental illness (smi) than in healthy older persons in the same age-group as the smi patients. Compared to the general population, smi patients are often in a poorer state of (physical) health and have a shorter life expectancy.<br/> AIM: To assess the value of screening older smi patients (≥ 60) for metabolic syndrome.<br/> METHOD: We performed a prospective evaluation of the metabolic screening outcome data relating to 100 older smi patients and 124 healthy older patients and compared the results.<br/> RESULTS: In our smi patients (average age 69 years; 52% bipolar disorder, 48% schizophrenia) the frequency of metabolic syndrome (43%) was no higher than in healthy older persons (39.5%, p = 0.60). However, in 51% of the smi sample, metabolic screening detected at least one metabolic abnormality in a patient with no previous history for that specific parameter.<br/> CONCLUSION: By making routine metabolic screening available to a greater number of older smi patients, we should be able to identify substantial numbers of metabolic abnormalities that have been previously overlooked.