Bipolar symptoms, somatic burden and functioning in older‐age bipolar disorder: A replication study from the global aging & geriatric experiments in bipolar disorder database (GAGE‐BD) project

Abstract

ObjectivesThe Global Aging & Geriatric Experiments in Bipolar Disorder Database (GAGE‐BD) project pools archival datasets on older age bipolar disorder (OABD). An initial Wave 1 (W1; n = 1369) analysis found both manic and depressive symptoms reduced among older patients. To replicate this finding, we gathered an independent Wave 2 (W2; n = 1232, mean ± standard deviation age 47.2 ± 13.5, 65% women, 49% aged over 50) dataset.Design/MethodsUsing mixed models with random effects for cohort, we examined associations between BD symptoms, somatic burden and age and the contribution of these to functioning in W2 and the combined W1 + W2 sample (n = 2601).ResultsCompared to W1, the W2 sample was younger (p < 0.001), less educated (p < 0.001), more symptomatic (p < 0.001), lower functioning (p < 0.001) and had fewer somatic conditions (p < 0.001). In the full W2, older individuals had reduced manic symptom severity, but age was not associated with depression severity. Age was not associated with functioning in W2. More severe BD symptoms (mania p ≤ 0.001, depression p ≤ 0.001) were associated with worse functioning. Older age was significantly associated with higher somatic burden in the W2 and the W1 + W2 samples, but this burden was not associated with poorer functioning.ConclusionsIn a large, independent sample, older age was associated with less severe mania and more somatic burden (consistent with previous findings), but there was no association of depression with age (different from previous findings). Similar to previous findings, worse BD symptom severity was associated with worse functioning, emphasizing the need for symptom relief in OABD to promote better functioning.

Facing Life in Old Age: Exploring Resilience in Older Adults with Bipolar Disorder

“…Recently findings from the GAGE-BD project suggest some changes in the clinical pattern during the aging process. For instance, while some clinical features appear to be less severe (like manic episodes and psychotic symptoms) [9,10] other factors emerge more prominent, such as suicide attempts, depressive symptoms, mixed episodes, somatic comorbidities, premature death, impairment in psychosocial functioning and cognitive dysfunction or dementia [10][11][12][13][14][15]. In addition, some reports have detected differences according to the age of onset (early vs late), in which late onset showed poorer cognitive outcomes and higher cerebrovascular risk [16].…”