Essential data dimensions for prospective international data collection in older age bipolar disorder (OABD): Recommendations from the GAGE‐BD group

Abstract

BackgroundBy 2030, over 50% of individuals living with bipolar disorder (BD) are expected to be aged ≥50 years. However, older age bipolar disorder (OABD) remains understudied. There are limited large‐scale prospectively collected data organized in key dimensions capable of addressing several fundamental questions about BD affecting this subgroup of patients.MethodsWe developed initial recommendations for the essential dimensions for OABD data collection, based on (1) a systematic review of measures used in OABD studies, (2) a Delphi consensus of international OABD experts, (3) experience with harmonizing OABD data in the Global Aging & Geriatric Experiments in Bipolar Disorder Database (GAGE‐BD, n ≥ 4500 participants), and (4) critical feedback from 34 global experts in geriatric mental health.ResultsWe identified 15 key dimensions and variables within each that are relevant for the investigation of OABD: (1) demographics, (2) core symptoms of depression and (3) mania, (4) cognition screening and subjective cognitive function, (5) elements for BD diagnosis, (6) descriptors of course of illness, (7) treatment, (8) suicidality, (9) current medication, (10) psychiatric comorbidity, (11) psychotic symptoms, (12) general medical comorbidities, (13) functioning, (14) family history, and (15) other. We also recommend particular instruments for capturing some of the dimensions and variables.ConclusionThe essential data dimensions we present should be of use to guide future international data collection in OABD and clinical practice. In the longer term, we aim to establish a prospective consortium using this core set of dimensions and associated variables to answer research questions relevant to OABD.

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

“…Our group of international scientists is in the process of attempting to replicate these other findings, which, if confirmed, can optimize generalizability of results and inform a better and much-needed understanding of clinical presentation of BD in the 2nd half of life. 31 In conclusion, this first replication analysis from the GAGE-BD project provides additional insight into OABD outcomes with respect to BD symptom presentation, functional status and somatic comorbidity burden. It also sheds light on the importance of large, diverse samples and how findings can vary depending on the features of each sample.…”

“…Other publications from the GAGE‐BD project have included investigation of somatic comorbidity among men and women, 6 BD subtypes, 30 mixed symptoms in OABD 8–10 and clinical characteristics of individuals prescribed lithium and prescribed antipsychotic drugs. Our group of international scientists is in the process of attempting to replicate these other findings, which, if confirmed, can optimize generalizability of results and inform a better and much‐needed understanding of clinical presentation of BD in the 2nd half of life 31 …”

Older age bipolar disorder

“…Future research is warranted to meet the needs of this special and expanding group. Researchers should collect longitudinal data on recently established essential data domains using validated measurement scales [ 27 ▪ ].…”

“…The distinctions between BD-I and BD-II and between EOBD and LOBD do not seem to represent clinically relevant subtypes for OABD patients. Future research should examine potential other disease specifiers in OABD populations [ 27 ▪ ], such as history of psychotic features, predominant polarity, episode density, and childhood maltreatment.…”

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

“…Approximately 25% of all patients with BD are older than 60 and this number is expected to increase to 50% in 2030 [6]. With the rapid aging of the world's population and 2 the increased life expectancy of people with chronic health conditions like BD, there is an urgent need to better characterize OABD [7,8].…”