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Review
. 2023 Sep 1;36(5):397-404.
doi: 10.1097/YCO.0000000000000883. Epub 2023 Jul 17.

Older age bipolar disorder

Alexandra J M Beunders  1   2   3 , Melis Orhan  4 , Annemiek Dols  5
Affiliations
Review

Older age bipolar disorder

Alexandra J M Beunders et al. Curr Opin Psychiatry. .

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.

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Conflict of interest statement

Dr Dols is the Principal Investigator of the Dutch Older Bipolar study (DOBi) and one of the initiators of the GAGE-BD project. Dr Dols is chair of the ISBD taskforce for OABD. This publication's contents are solely the responsibility of the authors and do not necessarily represent the official views of ISBD. The ISBD is a 401c3 nonprofit organization whose mission is to foster international collaboration in education and research. For more information, visitwww.isbd.org.

Figures

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Box 1
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FIGURE 1
FIGURE 1
Summary of recommendations for treatment of patients with older age bipolar disorder based on the latest literature, as discussed in the current review.
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