Geriatric bipolar disorder: Epidemiology, clinical features, assessment, and diagnosis
- Martha Sajatovic, MD
Martha Sajatovic, MD
- Director of Geriatric Psychiatry
- Professor of Psychiatry
- Case Western Reserve University School of Medicine
- Peijun Chen, MD, MPH, PhD
Peijun Chen, MD, MPH, PhD
- Associate Professor of Psychiatry
- Case Western Reserve University School of Medicine
- Staff Geriatric Psychiatrist, Louis Stokes Cleveland VA Medical Center
- Section Editors
- Paul Keck, MD
Paul Keck, MD
- Section Editor — Bipolar Disorders
- Professor of Psychiatry
- University of Cincinnati College of Medicine
- Kenneth E Schmader, MD
Kenneth E Schmader, MD
- Editor in Chief — Geriatric Medicine
- Section Editor — Geriatrics
- Chief, Division of Geriatrics
- Duke University
- Director, Geriatric Research Education and Clinical Center
- Durham VA Medical Centers
The clinical features and treatment of older bipolar patients differ from those of younger patients . Up to 25 percent of all bipolar patients are older adults , and the absolute number of geriatric bipolar patients is expected to increase as the world’s population ages over the next several decades [3,4].
This topic reviews the epidemiology, pathogenesis, clinical features, assessment, diagnosis, and differential diagnosis of geriatric bipolar disorder. The treatment and prognosis of geriatric bipolar disorder are discussed separately. (See "Geriatric bipolar disorder: Acute treatment" and "Geriatric bipolar disorder: Maintenance treatment".)
The minimum age used to define geriatric bipolar disorder is generally 60 years [5,6]. However, some authorities use an age cut-off of 50, 55, or 65 years . The International Society for Bipolar Disorders Task Force on Older-Age Bipolar Disorder recommends that older age bipolar disorder include individuals ≥50 years .
Geriatric bipolar disorder includes both aging patients whose mood disorder presented earlier in life and patients whose mood disorder presents for the first time in later life [1,8]. The International Society for Bipolar Disorders Task Force uses the term “older age bipolar disorder” instead of “geriatric bipolar disorder” .
The prevalence of geriatric bipolar disorder varies depending upon the setting and study sample.
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- General population
- Clinical settings
- Sex ratio
- CLINICAL FEATURES
- - Cognitive impairment
- - General medical disorders
- - Psychiatric disorders
- Substance use disorders
- Anxiety disorders
- Psychosocial functioning
- Course of illness
- - Mortality and suicide
- DIFFERENTIAL DIAGNOSIS
- General medical conditions
- INFORMATION FOR PATIENTS