Mania in old age: A First Prospective Study

Abstract

SUMMARYIn a first prospective study of manic illness in old age, 35 manic patients over the age of 60 were compared with 35 patients below the age of 40 on clinical and cognitive measures. CT scan comparisons were made between the elderly patients and age-matched healthy controls. Contrary to previously accepted teaching, the elderly were effectively clinically indistinguishable from the younger patients, except that the latter experienced more severe illnesses. CT and cognitive results, however, in the elderly group showed evidence of changes which support the view that cerebral organic factors play an important role in the genesis of affective disorder in old age.

The role of vascular risk factors in late onset bipolar disorder

“…In the latter group a variety of neurological and organic conditions such as stroke, space occupying lesions, infections and head injuries (Sweet, 1990;Ur et al, 1992;Robinson et al, 1998) are thought to play an important aetiological role, giving rise to the concept of 'secondary mania' (Krauthammer and Klerman, 1978). Around 17% to 43% of older people with mania have demonstrable cerebral organic disorders (Shulman and Post, 1980;Cummings and Mendez, 1984;Stone, 1989;Broadhead and Jacoby, 1990;Shulman et al, 1992;Young, 1992).…”

Factors related to hospitalization in elderly manic patients with early and late‐onset bipolar disorder

“…A bimodal distribution of age of onset of bipolar disorder has also been reported by Glasser and Rabins (1984); Broadhead and Jacoby (1990); Wylie et al (1999) and Cassidy and Carroll (2002), although different criteria for determining age of onset were used in each study. Examining age of onset in a wider population-based study of bipolar patients is needed before a consensus standard can be determined.…”

“…Attempts to differentiate between early-and late-onset cases have been complicated by the difficulty in determining the exact age of onset, especially for early-onset cases, (van Gerpen et al, 1999) and various criteria have been used, including age at first hospitalization, age at first onset of impairment-causing symptoms, and age at which the patient first met diagnostic criteria (Wylie et al, 1999). A bimodal distribution of age of onset of bipolar disorder has been reported by a number of investigators using cut-points ranging from ages 47 to 65 (Broadhead and Jacoby, 1990;Wylie et al, 1999;Cassidy and Carroll, 2002). However, these studies relied on visual inspection of the data and splitting at the median to inform their choice of cut-point.…”

Mental Disorders in Older Irish People: Incidence, Prevalence and Treatment

“…the agitation and excessive behaviours seen in younger patients are not often seen in older patients with mania (Young and Falk 1989). There is also further evidence from a more recent prospective study of mania in old age (Broadhead and Jacoby 1990). that mania is milder in older patients.…”