Somatic and psychiatric health burden of male and female older incarcerated adults in Switzerland: a retrospective cross-sectional study

Introduction: Incarcerated populations are ageing, yet their specific needs remain unclear, hindering adequate care planning. We provide a comprehensive overview of health burden among incarcerated adults in Switzerland, focusing on age-related differences. Methods: This is a retrospective cross-sectional analysis based on data extracted from medical records from 10 prisons and forensic-psychiatric institutions in Switzerland (N=384), comprising 151 older adults. We performed descriptive statistics for all variables. A multiple logistic regression analysis was conducted to identify diagnostic characteristics that differentiate older from younger incarcerated adults. We assessed whether a breakpoint exists in the association between age and total somatic disease burden using a segmented regression model. Results: Almost all older adults had at least one chronic condition (97%), of which the most common were substance use (20.4%) and mood disorders (14.3%), as well as endocrine and metabolic (25%), cardiovascular (17%) and respiratory (14%) diseases. Age differences emerged for affective (OR 1.58, 95% CI 1.23 to 2.05) and personality disorders (OR 2.06, 95% CI 1.60 to 2.66). We found an estimated breakpoint at age 39, at which the number of chronic somatic diseases began to increase at a rate greater than before. Conclusions: The increase in chronic somatic diseases around age 39 may warrant further examination of the commonly used age cut-off of 50. Given the high prevalence of chronic conditions among older adults, health services should shift from a focus on acute care to long-term chronic disease management, enhance screening for early disease detection and provide preventive care.