Bipolar symptoms, somatic burden, and functioning in older‐age bipolar disorder: Analyses from the Global Aging &amp; Geriatric Experiments in Bipolar Disorder Database project

Sajatovic, Martha; Dols, Annemiek; Rej, Soham; Almeida, Osvaldo P.; Beunders, Alexandra J.M.; Blumberg, Hilary P.; Briggs, Farren; Forester, Brent P.; Patrick, Regan; Forlenza, Orestes Vicente; Gildengers, Ariel; Jiménez, Esther; Vieta, Eduard; Mulsant, Benoit H.; Schouws, Sigfried; Paans, Nadine P.G.; Strejilevich, Sergio; Sutherland, Ashley; Tsai, Shang‐Ying; Wilson, Betsy; Eyler, Lisa T.

doi:10.1111/bdi.13119

Cited by 27 publications

(53 citation statements)

References 38 publications

(63 reference statements)

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“…110 Nevertheless, in OABD, we may be studying a healthier cohort than average group, given that those who reach old age have had lower rates of death due to medical comorbidities or suicidal behaviors. 111,112 Moreover, in recent decades, many efforts has been made to develop integral treatments for chronic BD patients, dedicated not only to address mental health, but also to optimize overall outcomes (physical health, treatment of comorbid diseases, stress management, compliance with pharmacological treatment, etc.) and this can contribute to reaching older age with better prognosis.…”

Section: Discussionmentioning

confidence: 99%

Cognition in older adults with bipolar disorder: An ISBD task force systematic review and meta‐analysis based on a comprehensive neuropsychological assessment

et al. 2022

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Objectives:We aim to characterize the cognitive performance in euthymic older adults with bipolar disorder (OABD) through a comprehensive neuropsychological assessment to obtain a detailed neuropsychological profile. Methods:We conducted a systematic search in MEDLINE/Pubmed, Cochrane, and PsycInfo databases. Original studies assessing cognitive function in OABD (age ≥50 years ) containing, at a minimum, the domains of attention/processing speed, memory, and executive functions were included. A random-effects meta-analysis was conducted to summarize differences between patients and matched controls in each cognitive domain. We also conducted meta-regressions to estimate the impact of clinical and socio-demographic variables on these differences.Results: Eight articles, providing data for 328 euthymic OABD patients and 302 healthy controls, were included in the meta-analysis. OABD showed worse performance in comparison with healthy controls, with large significant effect sizes (Hedge's g from −0.77 to −0.89; p < 0.001) in verbal learning and verbal and visual delayed memory. They also displayed statistically significant deficits, with moderate effect size, in processing speed, working memory, immediate memory, cognitive flexibility, verbal fluency, psychomotor function, executive functions, attention, inhibition, and recognition (Hedge's g from −0.52 to −0.76; p < 0.001), but not in language and visuoconstruction domains. None of the examined variables were associated with these deficits. Conclusions:Cognitive dysfunction is present in OABD, with important deficits in almost all cognitive domains, especially in the memory domain. Our results highlight the importance of including a routine complete neuropsychological assessment in OABD and also considering therapeutic strategies in OABD.

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Section: Discussionmentioning

confidence: 99%

Cognition in older adults with bipolar disorder: An ISBD task force systematic review and meta‐analysis based on a comprehensive neuropsychological assessment

et al. 2022

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“…About 19% of OAs with BD will develop dementia 35. BD can be more difficult to detect in OAs because it may present atypically, with less euphoria and more dysphoria, cognitive symptoms, and somatic complaints 9,36…”

Section: Screen For Manic Symptomsmentioning

confidence: 99%

Tailoring the mental health assessment to older adults

Davies¹

2023

The Nurse Practitioner

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“…23 "Moderate" and "severe" categories were merged given that one of the OABD groups did not have any participants in the "severe" level. Secondary dependent variables included: (1) mania, measured by the Young Mania Rating Scale [YMRS: 24 ], (2) level of functioning, measured by the Global Assessment of Functioning [GAF: 25 ], (3) current employment status, coded as a dichotomous variable (employed vs. unemployed), and (4) physical comorbidities grouped by organic systems (e.g., cardiovascular, gastrointestinal, hepatic/pancreatic, renal, genitourinary, musculoskeletal and endocrine) 26 and coded as presence/ absence of an illness.…”

Section: Dependentmentioning

confidence: 99%

Clinical correlates of late‐onset versus early‐onset bipolar disorder in a global sample of older adults

Lavin

Buck

Almeida

et al. 2022

Int J Geriat Psychiatry

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Objectives Late‐onset bipolar disorder (LOBD) represents a significant subgroup of bipolar disorder (BD). However, knowledge for this group is mostly extrapolated from small studies in subjects with early/mixed age of illness onset. In this global sample of older adults with BD (OABD: ≥50 years old) we aim to characterize the sociodemographic and clinical presentation of LOBD (≥40 years at BD onset) compared to early‐onset BD (EOBD: <40 years at BD onset). Methods The Global Aging and Geriatric Experiments in Bipolar Disorder consortium provided international data on 437 older age bipolar disorder participants. We compared LOBD versus EOBD on depression, mania, functionality, and physical comorbidities. Exploratory analyses were performed on participants with BD onset ≥50 years old. Results LOBD (n = 105) did not differ from EOBD (n = 332) on depression, mania, global functioning, nor employment status (p > 0.05). Late‐onset bipolar disorder was associated with higher endocrine comorbidities (odds ratio = 1.48, [95%CI = 1.0,12.1], p = 0.03). This difference did not remain significant when subjects with BD onset ≥50 years old were analyzed. Limitations This study is limited by the retrospective nature of the variable age of onset and the differences in evaluation methods across studies (partially overcame by harmonization processes). Conclusion The present analysis is in favor of the hypothesis that LOBD might represent a similar clinical phenotype as classic EOBD with respect to core BD symptomatology, functionality, and comorbid physical conditions. Large‐scale global collaboration to improve our understanding of BD across the lifespan is needed.

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Bipolar symptoms, somatic burden, and functioning in older‐age bipolar disorder: Analyses from the Global Aging & Geriatric Experiments in Bipolar Disorder Database project

Cited by 27 publications

References 38 publications

Cognition in older adults with bipolar disorder: An ISBD task force systematic review and meta‐analysis based on a comprehensive neuropsychological assessment

Cognition in older adults with bipolar disorder: An ISBD task force systematic review and meta‐analysis based on a comprehensive neuropsychological assessment

Tailoring the mental health assessment to older adults

Clinical correlates of late‐onset versus early‐onset bipolar disorder in a global sample of older adults

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