TY - JOUR
T1 - Clinical correlates of late-onset versus early-onset bipolar disorder in a global sample of older adults
AU - Lavin, Paola
AU - Buck, Gabriella
AU - Almeida, Osvaldo P.
AU - Su, Chien-Lin
AU - Eyler, Lisa T.
AU - Dols, Annemieke
AU - Blumberg, Hilary P.
AU - Forester, Brent P.
AU - Forlenza, Orestes V.
AU - Gildengers, Ariel
AU - Mulsant, Benoit H.
AU - Tsai, Shang-Ying
AU - Vieta, Eduard
AU - Schouws, Sigfried
AU - Briggs, Farren B. S.
AU - GAGE-BD Investigators
AU - Sutherland, Ashley
AU - Sarna, Kaylee
AU - Yala, Joy
AU - Orhan, Melis
AU - Korten, Nicole
AU - Sajatovic, Martha
AU - Rej, Soham
N1 - Funding Information: The authors are deeply grateful to Dr. Charles L. Bowden, who passed away in March of 2022, and his wife Virginia Massey Bowden, for establishing the Bowden Massey Research Initiative, which has supported the GAGE‐BD project. Dr. Bowden's deep commitment to advancing care for individuals living with BD is a continuously inspiring presence to our GAGE‐BD study team and the broader community of scientists focused on research in BD. This research received funding from the ISBD Bowden Massey Strategic Grant. Publisher Copyright: © 2022 John Wiley & Sons Ltd.
PY - 2022/12/1
Y1 - 2022/12/1
N2 - Objectives: Late-onset bipolar disorder (LOBD) represents a significant subgroup of bipolar disorder (BD). However, knowledge for this group is mostly extrapolated from small studies in subjects with early/mixed age of illness onset. In this global sample of older adults with BD (OABD: ≥50 years old) we aim to characterize the sociodemographic and clinical presentation of LOBD (≥40 years at BD onset) compared to early-onset BD (EOBD: <40 years at BD onset). Methods: The Global Aging and Geriatric Experiments in Bipolar Disorder consortium provided international data on 437 older age bipolar disorder participants. We compared LOBD versus EOBD on depression, mania, functionality, and physical comorbidities. Exploratory analyses were performed on participants with BD onset ≥50 years old. Results: LOBD (n = 105) did not differ from EOBD (n = 332) on depression, mania, global functioning, nor employment status (p > 0.05). Late-onset bipolar disorder was associated with higher endocrine comorbidities (odds ratio = 1.48, [95%CI = 1.0,12.1], p = 0.03). This difference did not remain significant when subjects with BD onset ≥50 years old were analyzed. Limitations: This study is limited by the retrospective nature of the variable age of onset and the differences in evaluation methods across studies (partially overcame by harmonization processes). Conclusion: The present analysis is in favor of the hypothesis that LOBD might represent a similar clinical phenotype as classic EOBD with respect to core BD symptomatology, functionality, and comorbid physical conditions. Large-scale global collaboration to improve our understanding of BD across the lifespan is needed.
AB - Objectives: Late-onset bipolar disorder (LOBD) represents a significant subgroup of bipolar disorder (BD). However, knowledge for this group is mostly extrapolated from small studies in subjects with early/mixed age of illness onset. In this global sample of older adults with BD (OABD: ≥50 years old) we aim to characterize the sociodemographic and clinical presentation of LOBD (≥40 years at BD onset) compared to early-onset BD (EOBD: <40 years at BD onset). Methods: The Global Aging and Geriatric Experiments in Bipolar Disorder consortium provided international data on 437 older age bipolar disorder participants. We compared LOBD versus EOBD on depression, mania, functionality, and physical comorbidities. Exploratory analyses were performed on participants with BD onset ≥50 years old. Results: LOBD (n = 105) did not differ from EOBD (n = 332) on depression, mania, global functioning, nor employment status (p > 0.05). Late-onset bipolar disorder was associated with higher endocrine comorbidities (odds ratio = 1.48, [95%CI = 1.0,12.1], p = 0.03). This difference did not remain significant when subjects with BD onset ≥50 years old were analyzed. Limitations: This study is limited by the retrospective nature of the variable age of onset and the differences in evaluation methods across studies (partially overcame by harmonization processes). Conclusion: The present analysis is in favor of the hypothesis that LOBD might represent a similar clinical phenotype as classic EOBD with respect to core BD symptomatology, functionality, and comorbid physical conditions. Large-scale global collaboration to improve our understanding of BD across the lifespan is needed.
KW - age at onset
KW - bipolar disorder
KW - elderly
KW - geriatrics
KW - older age bipolar disorder
KW - psychiatry
UR - http://www.scopus.com/inward/record.url?scp=85142938680&partnerID=8YFLogxK
U2 - https://doi.org/10.1002/gps.5833
DO - https://doi.org/10.1002/gps.5833
M3 - Article
C2 - 36317317
SN - 0885-6230
VL - 37
JO - International journal of geriatric psychiatry
JF - International journal of geriatric psychiatry
IS - 12
M1 - GPS5833
ER -