Primary prevention in geriatric psychiatry

BACKGROUND: It is estimated that the number of older adults with mental illness will increase from 4 million in 1970 to 15 million by 2030. The cost of untreated mental illness in the United States is estimated to be >$100 billion annually and nearly half of that cost can be attributed to persons age >= 60. In this paper we present a comprehensive review of empiric data available on primary prevention for the most common psychiatric illnesses in this patient population. METHODS: We did an English language literature review of published studies and selected only those with the strongest emphasis on primary prevention for the most common psychiatric illnesses in older adults. RESULTS: Modifiable and nonmodifiable risk factors and several primary prevention strategies have been described, several of them with positive outcomes mainly for depressive disorders and suicide. In conditions such as bipolar disorder, dementias, and geriatric schizophrenia, there is either a paucity of studies or no robust primary prevention strategies identified. CONCLUSIONS: Modification of risk factors, a healthy lifestyle that includes a healthy diet, exercise, socialization, and education are important aspects of primary prevention in elderly patients. Genetic engineering and vaccine therapies may open new and exciting opportunities for prevention of many psychiatric illnesses in the near future.