title: Risk of dementia and death in community-dwelling older men with bipolar disorder.
abstract: Bipolar disorder has been associated with cognitive decline, but confirmatory evidence from a community-derived sample of older people is lacking.
  
  
  
  To investigate the 13-year risk of dementia and death in older adults with bipolar disorder.
  
  
  
  Cohort study of 37 768 men aged 65-85 years. Dementia (primary) and death (secondary), as recorded by electronic record linkage, were the outcomes of interest.
  
  
  
  Bipolar disorder was associated with increased adjusted hazard ratio (HR) of dementia (HR = 2.30, 95% CI 1.80-2.94). The risk of dementia was greatest among those with <5 years of history of bipolar disorder or who had had illness onset after 70 years of age. Bipolar disorder was also associated with increased mortality (HR = 1.51, 95% CI 1.28-1.77). Competing risk regression showed that bipolar disorder was associated with increased hazard of death by suicide, accidents, pneumonia or influenza, and diseases of the liver and digestive system.
  
  
  
  Bipolar disorder in later life is associated with increased risk of dementia and premature death.
authors.affiliation: Osvaldo P. Almeida, PhD, School of Psychiatry & Clinical Neurosciences, University of Western Australia, Perth, WA Centre for Health & Ageing of Centre for Medical Research, Harry Perkins Institute of Medical Research, Perth, and Department of Psychiatry, Royal Perth Hospital, Perth; Kieran McCaul, PhD, WA Centre for Health & Ageing of Centre for Medical Research, Harry Perkins Institute of Medical Research, Perth; Graeme J. Hankey, MD, School of Medicine and Pharmacology, University of Western Australia, Perth, and Department of Neurology, Sir Charles Gairdner Hospital, Perth; Bu B. Yeap, PhD, School of Medicine and Pharmacology, University of Western Australia, Perth, and Department of Endocrinology, Fiona Stanley Hospital, Perth; Jonathan Golledge, MChir, Queensland Research Centre for Peripheral Vascular Disease, College of Medicine and Dentistry, James Cook University, Townsville, and Department of Vascular and Endovascular Surgery, The Townsville Hospital, Townsville; Leon Flicker, PhD, WA Centre for Health & Ageing of Centre for Medical Research, Harry Perkins Institute of Medical Research, Perth, School of Medicine and Pharmacology, University of Western Australia, Perth, and Department of Geriatric Medicine, Royal Perth Hospital, Perth, Australia osvaldo.almeida@uwa.edu.au.
authors.forename: Osvaldo P
authors.initials: OP
authors.lastname: Almeida
authors.affiliation: Osvaldo P. Almeida, PhD, School of Psychiatry & Clinical Neurosciences, University of Western Australia, Perth, WA Centre for Health & Ageing of Centre for Medical Research, Harry Perkins Institute of Medical Research, Perth, and Department of Psychiatry, Royal Perth Hospital, Perth; Kieran McCaul, PhD, WA Centre for Health & Ageing of Centre for Medical Research, Harry Perkins Institute of Medical Research, Perth; Graeme J. Hankey, MD, School of Medicine and Pharmacology, University of Western Australia, Perth, and Department of Neurology, Sir Charles Gairdner Hospital, Perth; Bu B. Yeap, PhD, School of Medicine and Pharmacology, University of Western Australia, Perth, and Department of Endocrinology, Fiona Stanley Hospital, Perth; Jonathan Golledge, MChir, Queensland Research Centre for Peripheral Vascular Disease, College of Medicine and Dentistry, James Cook University, Townsville, and Department of Vascular and Endovascular Surgery, The Townsville Hospital, Townsville; Leon Flicker, PhD, WA Centre for Health & Ageing of Centre for Medical Research, Harry Perkins Institute of Medical Research, Perth, School of Medicine and Pharmacology, University of Western Australia, Perth, and Department of Geriatric Medicine, Royal Perth Hospital, Perth, Australia.
authors.forename: Kieran
authors.initials: K
authors.lastname: McCaul
authors.affiliation: Osvaldo P. Almeida, PhD, School of Psychiatry & Clinical Neurosciences, University of Western Australia, Perth, WA Centre for Health & Ageing of Centre for Medical Research, Harry Perkins Institute of Medical Research, Perth, and Department of Psychiatry, Royal Perth Hospital, Perth; Kieran McCaul, PhD, WA Centre for Health & Ageing of Centre for Medical Research, Harry Perkins Institute of Medical Research, Perth; Graeme J. Hankey, MD, School of Medicine and Pharmacology, University of Western Australia, Perth, and Department of Neurology, Sir Charles Gairdner Hospital, Perth; Bu B. Yeap, PhD, School of Medicine and Pharmacology, University of Western Australia, Perth, and Department of Endocrinology, Fiona Stanley Hospital, Perth; Jonathan Golledge, MChir, Queensland Research Centre for Peripheral Vascular Disease, College of Medicine and Dentistry, James Cook University, Townsville, and Department of Vascular and Endovascular Surgery, The Townsville Hospital, Townsville; Leon Flicker, PhD, WA Centre for Health & Ageing of Centre for Medical Research, Harry Perkins Institute of Medical Research, Perth, School of Medicine and Pharmacology, University of Western Australia, Perth, and Department of Geriatric Medicine, Royal Perth Hospital, Perth, Australia.
authors.forename: Graeme J
authors.initials: GJ
authors.lastname: Hankey
authors.affiliation: Osvaldo P. Almeida, PhD, School of Psychiatry & Clinical Neurosciences, University of Western Australia, Perth, WA Centre for Health & Ageing of Centre for Medical Research, Harry Perkins Institute of Medical Research, Perth, and Department of Psychiatry, Royal Perth Hospital, Perth; Kieran McCaul, PhD, WA Centre for Health & Ageing of Centre for Medical Research, Harry Perkins Institute of Medical Research, Perth; Graeme J. Hankey, MD, School of Medicine and Pharmacology, University of Western Australia, Perth, and Department of Neurology, Sir Charles Gairdner Hospital, Perth; Bu B. Yeap, PhD, School of Medicine and Pharmacology, University of Western Australia, Perth, and Department of Endocrinology, Fiona Stanley Hospital, Perth; Jonathan Golledge, MChir, Queensland Research Centre for Peripheral Vascular Disease, College of Medicine and Dentistry, James Cook University, Townsville, and Department of Vascular and Endovascular Surgery, The Townsville Hospital, Townsville; Leon Flicker, PhD, WA Centre for Health & Ageing of Centre for Medical Research, Harry Perkins Institute of Medical Research, Perth, School of Medicine and Pharmacology, University of Western Australia, Perth, and Department of Geriatric Medicine, Royal Perth Hospital, Perth, Australia.
authors.forename: Bu B
authors.initials: BB
authors.lastname: Yeap
authors.affiliation: Osvaldo P. Almeida, PhD, School of Psychiatry & Clinical Neurosciences, University of Western Australia, Perth, WA Centre for Health & Ageing of Centre for Medical Research, Harry Perkins Institute of Medical Research, Perth, and Department of Psychiatry, Royal Perth Hospital, Perth; Kieran McCaul, PhD, WA Centre for Health & Ageing of Centre for Medical Research, Harry Perkins Institute of Medical Research, Perth; Graeme J. Hankey, MD, School of Medicine and Pharmacology, University of Western Australia, Perth, and Department of Neurology, Sir Charles Gairdner Hospital, Perth; Bu B. Yeap, PhD, School of Medicine and Pharmacology, University of Western Australia, Perth, and Department of Endocrinology, Fiona Stanley Hospital, Perth; Jonathan Golledge, MChir, Queensland Research Centre for Peripheral Vascular Disease, College of Medicine and Dentistry, James Cook University, Townsville, and Department of Vascular and Endovascular Surgery, The Townsville Hospital, Townsville; Leon Flicker, PhD, WA Centre for Health & Ageing of Centre for Medical Research, Harry Perkins Institute of Medical Research, Perth, School of Medicine and Pharmacology, University of Western Australia, Perth, and Department of Geriatric Medicine, Royal Perth Hospital, Perth, Australia.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Golledge
authors.affiliation: Osvaldo P. Almeida, PhD, School of Psychiatry & Clinical Neurosciences, University of Western Australia, Perth, WA Centre for Health & Ageing of Centre for Medical Research, Harry Perkins Institute of Medical Research, Perth, and Department of Psychiatry, Royal Perth Hospital, Perth; Kieran McCaul, PhD, WA Centre for Health & Ageing of Centre for Medical Research, Harry Perkins Institute of Medical Research, Perth; Graeme J. Hankey, MD, School of Medicine and Pharmacology, University of Western Australia, Perth, and Department of Neurology, Sir Charles Gairdner Hospital, Perth; Bu B. Yeap, PhD, School of Medicine and Pharmacology, University of Western Australia, Perth, and Department of Endocrinology, Fiona Stanley Hospital, Perth; Jonathan Golledge, MChir, Queensland Research Centre for Peripheral Vascular Disease, College of Medicine and Dentistry, James Cook University, Townsville, and Department of Vascular and Endovascular Surgery, The Townsville Hospital, Townsville; Leon Flicker, PhD, WA Centre for Health & Ageing of Centre for Medical Research, Harry Perkins Institute of Medical Research, Perth, School of Medicine and Pharmacology, University of Western Australia, Perth, and Department of Geriatric Medicine, Royal Perth Hospital, Perth, Australia.
authors.forename: Leon
authors.initials: L
authors.lastname: Flicker
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001714:Bipolar Disorder / Q000453:epidemiology* / Q000401:mortality; D015897:Comorbidity; D003704:Dementia / Q000453:epidemiology* / Q000401:mortality; D006801:Humans; D057187:Independent Living; D008297:Male