title: A descriptive study of older bipolar disorder residents living in New York City's adult congregate facilities.
abstract: OBJECTIVE
  Much of the research on geriatric bipolar disorder is from outpatient populations or epidemiological surveys with small samples. In contrast, in this study a descriptive analysis was conducted of geriatric and younger adult residents with bipolar disorder or mania in non-clinical adult congregate facilities (ACFs) in the greater New York City region.
  
  
  METHODS
  A total of 2602 ACF residents were evaluated in 19 facilities, across multiple demographic and health domains. Within this sample, 200 residents had chart diagnoses of bipolar disorder or mania. Among these, 50 geriatric residents (age ≥ 60) were compared to 50 younger adult residents (age < 50) on a number of demographic and health measures.
  
  
  RESULTS
  Based on chart diagnoses, the overall prevalence of bipolar disorder was 7.8%. Compared to other studies of outpatient, epidemiological, and census samples, both older and younger residents with bipolar disorder had higher rates of cognitive impairment, impairment in executive functioning, vision impairment, and proportion of residents who had never been married. The younger group also had higher rates of obesity and the elderly group had a greater proportion of residents without high-school education. Both age groups had rates of lithium or valproate use comparable to those found in outpatient studies. Comparing the two age groups, the elderly sample had lower overall cognitive and executive functioning, and was using a larger number of medication classes than the younger group. The elderly group also had a larger proportion of residents who were separated/divorced or widowed compared to the younger group, which had higher rates of never-married residents.
  
  
  CONCLUSIONS
  Overall, both age groups had relatively high rates of bipolar disorder, with significant cognitive impairment, medical burden, obesity, mental health service use, and lower education levels, as compared to outpatient, epidemiological, and census samples. Of note was the significant cognitive impairment across age groups.
authors.affiliation: Alpert Medical School, Brown University and Rhode Island Hospital, Providence, RI 02903, USA. tsheeran@lifespan.org
authors.forename: Thomas
authors.initials: T
authors.lastname: Sheeran
authors.forename: Rebecca L
authors.initials: RL
authors.lastname: Greenberg
authors.forename: Laura A
authors.initials: LA
authors.lastname: Davan
authors.forename: Jennifer A
authors.initials: JA
authors.lastname: Dealy
authors.forename: Robert C
authors.initials: RC
authors.lastname: Young
authors.forename: Martha L
authors.initials: ML
authors.lastname: Bruce
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001714:Bipolar Disorder / Q000150:complications* / Q000453:epidemiology* / Q000451:nursing; D003072:Cognition Disorders / Q000453:epidemiology / Q000209:etiology*; D005260:Female; D005853:Geriatrics; D006801:Humans; D008297:Male; D008605:Mental Health Services; D008875:Middle Aged; D009519:New York City / Q000453:epidemiology; D015995:Prevalence; D011569:Psychiatric Status Rating Scales; D055815:Young Adult