Psychiatric disorders among older U.S. women by socioeconomic and veteran status

Objectives: To examine among women ≥65 years: [1] differences in prevalence and incidence of psychiatric disorders, including substance use and mental health disorders, by veteran status; and [2] relationships of individual and neighborhood socioeconomic status (SES) with psychiatric disorders by veteran status. Methods: A total of 42,031 study-eligible women ≥65 years at enrollment (1993—1998) from the Women's Health Initiative (WHI) – including 1512 veterans – were evaluated for approximately 15 years of follow-up through linked WHI-Medicare databases. Multivariable logistic and Cox regression models were constructed for characteristics associated with prevalent and incident psychiatric disorders, respectively. Results: Psychiatric disorders affected a substantial proportion of women ≥65 years of age, with mood and anxiety disorders being the leading types of disorders. The overall prevalence and incidence rates of psychiatric disorders were 37.3 % and 25.5 per 1000 person-years, respectively. In adjusted models, frequencies of psychiatric disorders did not differ by veteran status. Also, lower education, household income, and neighborhood SES were related to higher frequencies of psychiatric disorders only among women non-veterans, whereas managerial/professional occupations were associated with lower frequencies of psychiatric disorders among women irrespective of their veteran status. However, interactions between veteran status and SES indicators in relation to psychiatric disorders were not statistically significant. Conclusions: Disparities in psychiatric disorders by individual-level and neighborhood-level SES may be distinct among older women veterans and non-veterans necessitating in-depth investigation.