Obsessive and Compulsive Symptoms in a National Sample of Older People: Prevalence, Comorbidity, and Associations With Cognitive Function

Abstract

To describe the prevalence of obsessive and compulsive symptoms in a national community sample of older adults, their comorbidity with mental disorders, and associations with cognitive impairment. A secondary analysis of data from a national survey. The 2000 British National Psychiatric Morbidity Survey. Primary analyses focused on 2,007 60- to 74-year-old community residents; secondary analyses compared these with 6,573 younger survey participants age 16-59 years. Obsessive and compulsive symptoms and mental disorders, including International Classification of Diseases, Tenth Revision (ICD-10) obsessive-compulsive disorder, were ascertained from the revised Clinical Interview Schedule and cognitive function from the modified Telephone Interview for Cognitive Status (global function, immediate and delayed word recall), verbal fluency (animal naming), and National Adult Reading Test (estimated verbal IQ). Health-related quality of life (SF12) was measured in addition to subjective impact. One-month prevalences of obsessive and compulsive symptoms and obsessive-compulsive disorder were 4.7%, 2.2%, and 0.4%, respectively (compared with 5.9%, 3.2%, and 0.8% in younger participants). High levels of comorbidity were found. Obsessive and compulsive symptoms were described as distressing by 67.8% and 70.2%, respectively, and both were associated with worse mental health-related quality of life. Obsessive symptoms were associated with lower verbal IQ and also with lower verbal fluency, which was not accounted for by education or estimated verbal IQ. Obsessions and compulsions had significant prevalence in this national older population. Consistent with previous reports, relative impairment in executive function (verbal fluency) was found in people reporting these symptoms.