Bipolar Disorder in Later Life: Epidemiology, Assessment, and Evidence-Based Care-View Presentation Slides

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The discussion focuses on bipolar disorders among older adults, emphasizing the different characteristics, assessment, and treatment options fitted for this demographic. Bipolar disorder (BD) involves recurring episodes of mania, hypomania, and depression, and the two subtypes are Bipolar I (BD-I) and Bipolar II (BD-II). Older Age Bipolar Disorder (OABD) is defined as BD presenting in individuals 50 years or older, making up about 25% of all BD cases, with a notable 70% being women.<br /><br />The presentation highlights that depression is often the initial symptom of OABD, rather than mania or hypomania, and there's a higher prevalence of cerebrovascular and neurological disorders among these patients. Notably, older adults with BD experience mood episodes with longer latency and a reduced family history of mood disorders, compared to their younger counterparts.<br /><br />For assessment, screening tools like the Mood Disorder Questionnaire and Young Mania Rating Scale are commonly used. Treatment encompasses both nonpharmacologic (e.g., Medication Adherence Skills Training) and pharmacologic interventions, including lithium, anticonvulsants, antipsychotics, antidepressants, benzodiazepines, and electroconvulsive therapy (ECT). Lithium remains a preferred choice, especially for its potential to reduce suicide risk and possibly cognitive decline, although caution is advised due to possible side effects and interactions with other medications.<br /><br />Anticonvulsants like lamotrigine show efficacy in delaying mood episode intervention. Various antipsychotics, including quetiapine and lurasidone, are employed for treating different aspects of BD. ECT is advocated for severe cases requiring rapid symptom alleviation.<br /><br />The presentation concludes with a comparison between OABD and early-onset BD, highlighting differences in symptoms, comorbidities, and healthcare service utilization among older patients, underscoring the need for age-specific management approaches for BD.

Keywords

Bipolar Disorder

Older Adults

OABD

Depression

Treatment Options

Lithium

Anticonvulsants

Antipsychotics

Electroconvulsive Therapy

Age-specific Management