Epidemiology, etiology, and treatment of geriatric mania

Few prospective studies have focused on elderly patients with mania, despite the rapidly aging population and the difficulties encountered in treating older patients with manic symptoms. Retrospective studies generally have found that the number of new cases of mania and the prevalence of mania in the population decrease with age, although there is evidence to contradict this widely held belief. The diagnosis of mania in the elderly is confounded by the overlap of manic symptoms with other syndromes that occur with aging, including dementia, delirium, and medical illnesses. The treatment of mania is more difficult in the elderly, and new treatments such as the atypical antipsychotics and the anticonvulsants take on a more important role in treatment regimens for older patients.