Mood and substance use disorders in older adults with HIV/AIDS: methodological issues and preliminary evidence.

Overview

OBJECTIVE: To review methodological issues and available data regarding the prevalence of psychiatric disorders in HIV-positive people over the age of 50 years. RESULTS: We were unable to find any published data providing prevalence rates of depression and substance use disorders, the most common psychiatric disorders, for HIV-positive adults over 50 years, compared with HIV-seronegative adults over 50 years or HIV-positive adults under the age of 50 years. Epidemiological data from population studies in the United States and internationally consistently show a substantial decline in the rates of depression and substance use disorders with progressive age in the general population. Preliminary data in our small sample suggest that, unlike HIV-seronegative older adults whose rates of disorder decline substantially compared with younger adults, this decline was not observed for older HIV-positive adults. CONCLUSION: Given the relative infrequency of disorder and the need to control both for age and HIV status, a large-scale study with four groups is required: HIV-positive men and women under and over 50 years of age, and HIV-negative men and women under and over 50 years of age.