Older age bipolar disorder

Current Opinion in Psychiatry, vol. 36, pp. 397–404

Abstract

PURPOSE OF REVIEW: Older age bipolar disorder (OABD) refers to patients with bipolar disorder aged 50 years and over. There is a paucity of evidence-based guidelines specific to OABD, but in recent years, several studies have been published on OABD. The current review synthesizes previous literature (up to January 1, 2021) as well as most recent literature on OABD (since January 1, 2021). RECENT FINDINGS: This review covers the following themes: diagnosis and specifiers, clinical course, psychosocial functioning, cognition, physical comorbidities, and pharmacotherapy. On the basis of the latest data, specific clinical recommendations are proposed for each theme. SUMMARY: OABD forms a more complex subgroup of bipolar disorder, with an increased risk of cognitive deficits, physical comorbidities, impaired psychosocial functioning, and premature death. The distinctions between BD-I and BD-II and between EOBD and LOBD do not clinically represent relevant subtypes for OABD patients. Mental healthcare professionals should treat all OABD patients with an integrative care model that takes into account cognitive and physical comorbidities and that contains elements aimed at improvement of psychosocial functioning and quality of life. Older age itself should not be a reason to withhold lithium treatment. Future research should collect data on essential data domains using validated measurement scales.

Authors 3

1. Alexandra J.M. Beunders corresponding

   University Medical Center Utrecht · Amsterdam UMC Location Vrije Universiteit Amsterdam · Amsterdam Public Health · GGZ inGeest

   Affiliation as printed

   Amsterdam Public Health Research Institute, Mental Health, Amsterdam

   Amsterdam UMC Location Vrije Universiteit Amsterdam, Psychiatry

   GGZ inGeest Specialized Mental Healthcare

   This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. http://creativecommons.org/licenses/by/4.0; aGGZ inGeest Specialized Mental Healthcare; bAmsterdam UMC Location Vrije Universiteit Amsterdam, Psychiatry; cAmsterdam Public Health Research Institute, Mental Health, Amsterdam; dInstitute of Clinical Psychology, Leiden University, Leiden; eDepartment of Psychiatry, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht, The Netherlands

2. Melis Orhan Aachen Institute of Clinical Psychology

   Leiden University · University Medical Center Utrecht · Amsterdam UMC Location Vrije Universiteit Amsterdam

   Affiliation as printed

   Institute of Clinical Psychology, Leiden University, Leiden

   This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. http://creativecommons.org/licenses/by/4.0; aGGZ inGeest Specialized Mental Healthcare; bAmsterdam UMC Location Vrije Universiteit Amsterdam, Psychiatry; cAmsterdam Public Health Research Institute, Mental Health, Amsterdam; dInstitute of Clinical Psychology, Leiden University, Leiden; eDepartment of Psychiatry, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht, The Netherlands

3. Annemiek Dols

   University Medical Center Utrecht · Amsterdam UMC Location Vrije Universiteit Amsterdam

   Affiliation as printed

   Department of Psychiatry, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht, The Netherlands

   This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. http://creativecommons.org/licenses/by/4.0; aGGZ inGeest Specialized Mental Healthcare; bAmsterdam UMC Location Vrije Universiteit Amsterdam, Psychiatry; cAmsterdam Public Health Research Institute, Mental Health, Amsterdam; dInstitute of Clinical Psychology, Leiden University, Leiden; eDepartment of Psychiatry, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht, The Netherlands