Older men with bipolar disorder: Clinical associations with early and late onset illness

Almeida, Osvaldo P.; Hankey, Graeme J.; Yeap, Bu B.; Golledge, Jonathan; Flicker, Leon

doi:10.1002/gps.4957

Cited by 21 publications

(16 citation statements)

References 26 publications

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“…The results showed that regardless of the age of BD onset, these individuals had an increased risk for dementia (Age < 50 ‐ HR 3.46, 95% CI 2.41–4.95; Age ≥ 50–HR 2.26, 95% CI 1.76–2.90). Incident dementia was higher when onset of BD illness was before 50 years and after 60 years, even though this effect was not significant .…”

Section: Resultsmentioning

confidence: 81%

“…The systematic review included five cohort studies assessing whether BD is a risk factor for dementia. All studies showed that BD presents with an increased risk for developing dementia . Kessing et al included all inpatients with a main diagnosis of BD, major depression, osteoarthritis, or diabetes from January 1, 1977, to December 31, 1993, with no history of dementia before selection.…”

Section: Resultsmentioning

confidence: 99%

“…Thus, it appears that changes in mood later in life may represent, in at least some cases, an early clinical expression of neurodegenerative processes that will ultimately lead to the diagnosis of dementia . Finally, Almeida et al included men aged 65–85 during 1996–1998 from a specific Australian population. Then, they retrieved information about the diagnosis of BD from another database and started a follow‐up until December 31, 2013.…”

Section: Resultsmentioning

confidence: 99%

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Risk of dementia in bipolar disorder and the interplay of lithium: a systematic review and meta‐analyses

Velosa

Delgado

Finger

et al. 2020

Acta Psychiatr Scand

116

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Cardoso T. Risk of dementia in bipolar disorder and the interplay of lithium: a systematic review and meta-analyses.Objectives: To assess whether bipolar disorder (BD) increases the rate of dementia and whether lithium is related to a lower risk of dementia in BD. Methods: A total of 10 studies (6859 BD; 487 966 controls) were included in the meta-analysis to test whether BD is a risk factor for dementia. In addition, five studies (6483 lithium; 43 496 non-lithium) were included in the meta-analysis about the potential protective effect of lithium in BD. Results: BD increases the risk of dementia (odds ratio (OR): 2.96 [95% CI: 2.09-4.18], P < 0.001), and treatment with lithium decreases the risk of dementia in BD (OR: 0.51 [95% CI: 0.36-0.72], P < 0.0001). In addition, secondary findings from our systematic review showed that the risk of progression to dementia is higher in BD than in major depressive disorder (MDD). Moreover, the number of mood episodes predicted the development of dementia in BD. Conclusion: Individuals with BD are at higher risk of dementia than both the general population or those with MDD. Lithium appears to reduce the risk of developing dementia in BD.• The diagnosis of bipolar disorder increases the risk to develop dementia almost three-fold.• Treatment with lithium decreased the risk for dementia by 49% in individuals with bipolar disorder compared to controls/non-lithium treated people with BD.• Dementia can be seen as an endpoint of bipolar disorder staging model. Limitations• There is a possibility that publication bias may have potentially inflated our results.• The majority of the evidence comes from registry-based studies that have several limitations such as data collection, reliability of diagnosis, selection bias, and confounders.• Additional studies are needed to understand the pathophysiology of BD that leads to cognitive deterioration, brain abnormalities, and to the development of dementia. 510

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Section: Resultsmentioning

confidence: 81%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Risk of dementia in bipolar disorder and the interplay of lithium: a systematic review and meta‐analyses

Velosa

Delgado

Finger

et al. 2020

Acta Psychiatr Scand

116

View full text Add to dashboard Cite

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“…Taken together, these results suggest that the course of affective symptoms seems to be relatively benign for most men with BD who reach old age. We are also mindful of the fact that differential mortality could conceivably confound the association between BD with hospital contacts, although that seems an unlikely explanation for our findings because older men with EOBD and LOBD have similar mortality rates during follow up (Almeida et al, 2018a).…”

Section: Discussionmentioning

confidence: 90%

“…Such a bias would have diluted the differences between EOBD and LOBD. In a previous study we have shown that changing the age that defines LOBD has limited effect on clinical associations, which suggests that error associated with the definition of EOBD and LOBD was most likely minimal (Almeida et al, 2018a;Almeida et al, 2016b). We are also mindful of the fact that WADLS records are only available from 1966, which means that earlier mental health contacts would have not been available.…”

Section: Strengths and Limitationsmentioning

confidence: 97%

Older men with bipolar disorder diagnosed in early and later life: Physical health morbidity and general hospital service use

Almeida

Hankey

Yeap

et al. 2018

Journal of Affective Disorders

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Older men with BD experience greater health morbidity than men without BD. Older men with BD access hospital services for the management of physical morbidities earlier and more frequently than men without BD. Age at the time of diagnosis of BD has limited impact on the risk of contact with general medical services, although subtle differences in the physical morbidity of men with EOBD and LOBD warrant further investigation.

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Psychiatric disorders and risk of subsequent dementia: Systematic review and meta‐analysis of longitudinal studies

Stafford

Chung

Sommerlad

et al. 2022

Int J Geriat Psychiatry

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Objectives Although psychiatric disorders have been found to be associated with increased risk of dementia, previous findings are mixed, and the nature of these relationships remains poorly understood. We examined longitudinal associations between depression, anxiety, post‐traumatic stress disorders (PTSD), bipolar disorder (BPD), psychotic disorders and subsequent dementia. Methods We searched three databases for longitudinal, population‐based studies investigating associations between psychiatric disorders and dementia (PROSPERO registration: CRD42020209638). We conducted narrative synthesis, and random‐effects meta‐analyses to obtain pooled estimates. We used meta‐regression and stratified analyses to examine variation by sex, age‐at‐onset and follow‐up time. Results Fifty‐seven citations met eligibility criteria. Most studies focussed on depression (n = 33), which was associated with subsequent all‐cause dementia (pooled relative risk [RR]: 1.96, 95% confidence interval [CI]: 1.59–2.43; I2 = 96.5%), Alzheimer's Disease (pooled RR: 1.9, 95% CI: 1.52–2.38; I2 = 85.5%), and Vascular Dementia (pooled RR: 2.71, 95% CI: 2.48–2.97; I2 = 0). Associations were stronger in studies with shorter follow‐up periods and for severe and late‐onset depression. Findings regarding anxiety were mixed, and we did not find evidence of an overall association (pooled RR: 1.18, 95% CI: 0.96–1.45; I2 = 52.2%, n = 5). Despite sparse evidence, psychotic disorders (pooled RR: 2.19, 95% CI: 1.44–3.31; I2 = 99%), PTSD and BPD were associated with subsequent dementia. Conclusions People with psychiatric disorders represent high‐risk groups for dementia, highlighting the importance of ongoing symptom monitoring in these groups. Findings regarding temporality and age‐at‐onset indicate that depression symptoms could reflect prodromal dementia for some individuals. Further longitudinal research is required to determine whether psychiatric disorders represent causal risk factors or early markers of dementia neuropathology.

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Older men with bipolar disorder: Clinical associations with early and late onset illness

Abstract: Our results indicate that the clinical associations and outcomes of older adults living with BD are not markedly influenced by age of onset. However, mortality data suggest that differences between older adults with BD onset before and after age 60 years should continue to be explored.

Cited by 21 publications

References 26 publications

Risk of dementia in bipolar disorder and the interplay of lithium: a systematic review and meta‐analyses

Risk of dementia in bipolar disorder and the interplay of lithium: a systematic review and meta‐analyses

Older men with bipolar disorder diagnosed in early and later life: Physical health morbidity and general hospital service use

Psychiatric disorders and risk of subsequent dementia: Systematic review and meta‐analysis of longitudinal studies

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