Screening for syphilis in an aged psychiatrically impaired population

A serum Venereal Disease Research Laboratories (VDRL) test was carried out in 216 elderly patients with dementia or 'functional ' psychiatric illness, or both, as part of a community based screening program. The VDRL test was positive in 13 patients, 11 of whom (5.1%) had an actual past or present syphilitic infection as confirmed by the fluorescent treponemal antibody absorption test (FTA Abs). In six patients (2.8%) syphilis was newly detected, and in another two patients previously detected syphilis had been inadequately treated. Only two (0.9%) biologic false positive reactors were detected. These results question the belief that aging per se is a common cause of the biologic false positive reaction; and indicate a relatively high incidence of past or present syphilitic infection in geriatric patients with psychiatric illness in the community who have been referred for crisis intervention.