TY - JOUR
T1 - Sex Differences Among Older Adults With Bipolar Disorder
T2 - Results From the Global Aging & Geriatric Experiments in Bipolar Disorder (GAGE-BD) Project
AU - Blanken, Machteld A. J. T.
AU - Oudega, Mardien L.
AU - Almeida, Osvaldo P.
AU - Schouws, Sigfried N. T. M.
AU - Orhan, Melis
AU - Beunders, Alexandra J. M.
AU - Klumpers, Ursula M. H.
AU - Sonnenberg, Caroline
AU - Blumberg, Hilary P.
AU - Eyler, Lisa T.
AU - Forester, Brent P.
AU - Forlenza, Orestes V.
AU - Gildengers, Ariel
AU - Mulsant, Benoit H.
AU - Rajji, Tarek
AU - Rej, Soham
AU - Sarna, Kaylee
AU - Sutherland, Ashley
AU - Yala, Joy
AU - Vieta, Eduard
AU - Tsai, Shangying
AU - Briggs, Farren B. S.
AU - Sajatovic, Martha
AU - Dols, Annemiek
N1 - Funding Information: Research reported in this publication was supported by the International Society for Bipolar Disorders (ISBD) Bowden Massey Strategic Research Initiative in Bipolar Disorder Award, and made possible by logistical support from the ISBD. The Health In Men Study was supported by the National Health and Medical Research Council of Australia (NHMRC); US National Institute of Mental Health ( R01MH070902 , R01MH113230 , R01MH084921 ); Desert-Pacific Mental Illness Research Education and Clinical Center ; MH103318 ; ISBD Bowden Grant; EV thanks the support by CIBER - Consorcio Centro de Investigación Biomédica en Red - CB07/09/0004 ), Instituto de Salud Carlos III, Spanish Ministry of Science and Innovation and grants PI18/00805 and PI21/00787 , integrated into the Plan Nacional de I+D+I and co-financed by the ISCIII-Subdirección General de Evaluación and the Fondo Europeo de Desarrollo Regional (FEDER); the Instituto de Salud Carlos III; the Secretaria d'Universitats i Recerca del Departament d'Economia i Coneixement (2021 SGR 01358), the CERCA Programme, and the Departament de Salut de la Generalitat de Catalunya for the PERIS grant SLT006/17/00357 . Thanks also for the support of the European Union Horizon 2020 research and innovation program (EU.3.1.1. Understanding health, wellbeing and disease: Grant No 754907 and EU.3.1.3. Treating and managing disease: Grant No 945151 ). This publication's contents are solely the responsibility of the authors and do not necessarily represent the official views of ISBD. The ISBD is a 401c3 nonprofit organization whose mission is to foster international collaboration in education and research. For more information, visit www.isbd.org and www.gage-bd.org . Publisher Copyright: © 2023 The Authors
PY - 2023
Y1 - 2023
N2 - Objective: Sex-specific research in adult bipolar disorder (BD) is sparse and even more so among those with older age bipolar disorder (OABD). Knowledge about sex differences across the bipolar lifespan is urgently needed to target and improve treatment. To address this gap, the current study examined sex differences in the domains of clinical presentation, general functioning, and mood symptoms among individuals with OABD. Methods: This Global Aging & Geriatric Experiments in Bipolar Disorder (GAGE-BD) study used data from 19 international studies including BD patients aged ≥50 years (N = 1,185: 645 women, 540 men).A comparison of mood symptoms between women and men was conducted initially using two-tailed t tests and then accounting for systematic differences between the contributing cohorts by performing generalized linear mixed models (GLMMs). Associations between sex and other clinical characteristics were examined using GLMM including: age, BD subtype, rapid cycling, psychiatric hospitalization, lifetime psychiatric comorbidity, and physical health comorbidity, with study cohort as a random intercept. Results: Regarding depressive mood symptoms, women had higher scores on anxiety and hypochondriasis items. Female sex was associated with more psychiatric hospitalizations and male sex with lifetime substance abuse disorders. Conclusion: Our findings show important clinical sex differences and provide support that older age women experience a more severe course of BD, with higher rates of psychiatric hospitalization. The reasons for this may be biological, psychological, or social. These differences as well as underlying mechanisms should be a focus for healthcare professionals and need to be studied further.
AB - Objective: Sex-specific research in adult bipolar disorder (BD) is sparse and even more so among those with older age bipolar disorder (OABD). Knowledge about sex differences across the bipolar lifespan is urgently needed to target and improve treatment. To address this gap, the current study examined sex differences in the domains of clinical presentation, general functioning, and mood symptoms among individuals with OABD. Methods: This Global Aging & Geriatric Experiments in Bipolar Disorder (GAGE-BD) study used data from 19 international studies including BD patients aged ≥50 years (N = 1,185: 645 women, 540 men).A comparison of mood symptoms between women and men was conducted initially using two-tailed t tests and then accounting for systematic differences between the contributing cohorts by performing generalized linear mixed models (GLMMs). Associations between sex and other clinical characteristics were examined using GLMM including: age, BD subtype, rapid cycling, psychiatric hospitalization, lifetime psychiatric comorbidity, and physical health comorbidity, with study cohort as a random intercept. Results: Regarding depressive mood symptoms, women had higher scores on anxiety and hypochondriasis items. Female sex was associated with more psychiatric hospitalizations and male sex with lifetime substance abuse disorders. Conclusion: Our findings show important clinical sex differences and provide support that older age women experience a more severe course of BD, with higher rates of psychiatric hospitalization. The reasons for this may be biological, psychological, or social. These differences as well as underlying mechanisms should be a focus for healthcare professionals and need to be studied further.
KW - Sex differences
KW - bipolar disorder
KW - gender
KW - geriatrics
KW - men
KW - older age bipolar disorder (OABD)
KW - sex
KW - women
UR - http://www.scopus.com/inward/record.url?scp=85177046092&partnerID=8YFLogxK
U2 - https://doi.org/10.1016/j.jagp.2023.10.008
DO - https://doi.org/10.1016/j.jagp.2023.10.008
M3 - Article
C2 - 37981507
SN - 1064-7481
JO - American Journal of Geriatric Psychiatry
JF - American Journal of Geriatric Psychiatry
ER -