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Bipolar disorder in old age.

K I Shulman1, N Herrmann

  • 1Department of Psychiatry, University of Toronto, Ontario. ken.shulman@sunnybrook.on.ca

Canadian Family Physician Medecin De Famille Canadien
|June 1, 1999
PubMed
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Mania in older adults often requires hospitalization and is linked to neurological issues like cerebrovascular disease. Careful assessment and management are crucial for this vulnerable population.

Area of Science:

  • Geriatric psychiatry
  • Neurology
  • Epidemiology of mental disorders

Background:

  • Bipolar disorder presentation and management in the elderly differ significantly from younger populations.
  • Old age is associated with increased risk for neurological comorbidities.
  • Limited evidence exists for effective treatment strategies in geriatric bipolar disorder.

Purpose of the Study:

  • To review the classification and clinical characteristics of bipolar disorders in old age.
  • To examine the epidemiology of geriatric bipolar disorder.
  • To highlight neurologic comorbidity, high mortality, and management challenges.

Main Methods:

  • Review of retrospective chart reviews and cohort studies.
  • Synthesis of evidence from younger populations and limited geriatric case reports.

Related Experiment Videos

  • Focus on clinical presentation, associated conditions, and treatment outcomes.

    • Main Results:

    • Mania in old age frequently necessitates hospitalization, despite being rare in the community.
    • Strong association observed between late-onset mania and neurologic disorders, particularly right-hemisphere cerebrovascular disease.
    • High rates of morbidity and mortality are characteristic of bipolar disorder in the elderly.
    • Management involves cautious use of mood stabilizers like lithium and divalproex.

    Conclusions:

    • Late-onset mania warrants thorough neurological assessment, especially for cerebrovascular disease.
    • Close clinical monitoring is essential for managing bipolar disorder in older adults.
    • Understanding the interplay between neurological conditions and bipolarity is critical for effective geriatric psychiatric care.