Clinical features, comorbidity, and cognitive impairment in elderly bipolar patients.
BACKGROUND
Data specific to late-life bipolar disorder (BD) are limited. Current research is sparse and present guidelines are not adapted to this group of patients.


OBJECTIVE
We present a literature review on clinical characteristics, comorbidities, and cognitive impairment in patients with late-life BD. This review discusses common comorbidities that affect BD elders and how aging might affect cognition and treatment.


METHODS
Eligible studies were identified in MedLine by the Medical Subject Headings terms "bipolar disorder" and "aged". We only included original research reports published in English between 2012 and 2015.


RESULTS
From 414 articles extracted, 16 studies were included in the review. Cardiovascular and respiratory conditions, type II diabetes, and endocrinological abnormalities were observed as highly prevalent. BD is associated with a high suicide risk. Bipolar elderly had an increased risk of dementia and performed worse on cognitive screening tests compared to age-matched controls across different levels of cognition. Despite high rates of medical comorbidity among bipolar elderly, a systematic under-recognition and undertreatment of cardiovascular disease have been suggested.


CONCLUSIONS
There was a high burden of physical comorbidities and cognitive impairment in late-life BD. Bipolar elderly might be under-recorded and undertreated in primary medical care, indicating that this group needs an adapted clinical assessment and specific clinical guidelines need to be established.
Department of Psychiatry, Sorlandet Hospital, Arendal, Norway.
Ida Vikan
IV
Rise
Research Unit, Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain; Faculty of Medicine, Universitat de Barcelona, Barcelona, Spain; CIBERSAM (Centro de Investigación Biomédica En Red de Salud Mental), Madrid, Spain.
Josep Maria
JM
Haro
Department of Psychiatry, North-Trondelag Hospital Trust, Levanger, Norway; Department of Medicine, Institute of Neuromedicine, Norwegian University of Science and Technology, Trondheim, Norway.
Bjørn
B
Gjervan
aged; bipolar disorder; cognition; comorbidity; impairment; treatment