超高齢期の精神疾患

Psychiatric Disorders in the Oldest-Old

平均寿命延伸に伴い80歳以上の超高齢者は増えたが，その精神疾患についての検討は十分ではない。超高齢期の精神疾患では，身体疾患の合併や脳の器質的変化を伴うことが多いこと，精神症状は典型的でなく急激に変化すること，加齢により薬物療法が複雑となることに注意を要する。本稿では，精神病性障害（統合失調症，妄想性障害，緊張病，老年期特有の精神病性障害），うつ病，アパシー，不安症，身体症状症を概説した。

Abstract

The number of super-aged people over 80 years has increased with the life expectancy; however, studies on their psychiatric disorders are lacking. The characteristics of psychiatric disorders in the elderly are often complicated by physical diseases and organic changes in the brain. Psychiatric symptoms change atypically and rapidly. In the oldest-old, it is difficult to hear about the present condition of the patient and the aging process complicates drug therapy. In this paper, I outlined the diagnosis, symptoms, and treatments of: 1. psychotic disorders in the oldest-old including (A) schizophrenia comprised of (i) schizophrenia in late life and (ii) late-onset schizophrenia, (B) delusional disorder, (C) catatonia, and (D) late-onset psychotic disorders (conventional diagnosis); 2. depression; 3. apathy; 4. anxiety disorder; and 5. somatoform disorder.