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Review
. 2021 May 27:10:2021-1-8.
doi: 10.7573/dic.2021-1-8. eCollection 2021.

Evaluation and treatment of older-age bipolar disorder: a narrative review

Rajesh R Tampi  1   2   3 , Pallavi Joshi  3 , Gargi Bhattacharya  4 , Sheila Gupta  5
Affiliations
Review

Evaluation and treatment of older-age bipolar disorder: a narrative review

Rajesh R Tampi et al. Drugs Context. .

Abstract

Objectives: This narrative review aims to synthesize information from the literature regarding older-age bipolar disorder (OABD) in order to provide up-to-date information on this important illness.

Methods: We searched Ovid (Medline, Embase and PsychInfo) on October 1, 2020, using the keywords "bipolar disorder", "older adults" and "elderly" to identify relevant articles on OABD. Additionally, the bibliography of identified articles was reviewed for pertinent studies.

Discussions: OABD is a term that is used to describe bipolar disorder (BD) occurring amongst individuals ≥50 years of age. Evidence indicates that OABD accounts for a quarter of all cases of BD. When compared to individuals with early-onset BD, individuals with OABD have a greater association with cerebrovascular disease and other neurological disorders, less family history of mood disorders, and utilize almost four times the total amount of mental health services. In addition, they are four times more likely to have psychiatric hospitalizations when compared to age-matched controls. Despite a dearth of controlled studies on the use of pharmacotherapy amongst individuals with OABD, available evidence from mixed-age studies indicates the efficacy of commonly used medications in individuals with early-onset BD. Additionally, psychosocial treatments have been found to be effective as adjunctive management strategies amongst individuals with OABD. Furthermore, electroconvulsive therapy may be effective in the treatment of refractory cases of OABD.

Conclusions: There is a great need for an improved understanding of the phenomenology and neurobiology of OABD. Additionally, research into effective treatments for this serious psychiatric disorder will mitigate the suffering of individuals with OABD.

Keywords: antipsychotics; bipolar disorder; early-onset bipolar disorder; electroconvulsive therapy; lithium; mood stabilizers; older-age bipolar disorder; psychosocial treatments.

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Conflict of interest statement

Disclosure and potential conflicts of interest: The authors declare that they have no conflicts of interest relevant to this manuscript. The International Committee of Medical Journal Editors (ICMJE) Potential Conflicts of Interests form for the authors is available for download at: https://www.drugsincontext.com/wp-content/uploads/2021/05/dic.2021-1-8-COI.pdf

Figures

Figure 1
Figure 1
Assessment of bipolar disorder amongst older adults.,,–
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