Late Onset Bipolar Disorder: Clinical Characterization

Abstract

Introduction

Bipolar disease is a chronic mental illness with a deep personal and social impact. Alongside with the considerable progress in understanding and treating bipolar disorder, and despite the growing interest in geriatric psychiatry, late onset bipolar disorder has been relatively little studied so far.

Objectives

To review the literature regarding the epidemiology, characteristics and clinical implications of late onset bipolar disorder.

Methodology

A literature review was performed by searching articles in Pubmed, using the following search terms: “late onset bipolar disorder” and “elderly bipolar disorder”. All literature in English published in the last 15 years was examined and 11 articles were selected.

Results

Although the frequency of bipolar disorder type 1 or 2 decrease with age, approximately 6 to 8% of the new cases of bipolar disorder develop in people over 60 years of age. Clinically, late-onset bipolar disorder appears to be associated with a better level of pre-morbid functioning, a less severe psychopathology as well as a smaller family burden of psychiatric illness. The term “secondary mania” postulated by Krauthmamer Klerman has been used to describe a bipolar disease variant associated with a variety of organic factors that may be responsible for this late-onset disease.

Conclusions

Late onset bipolar disorder is probably a different diagnostic than the entity that occurs in younger patients, since it presents with a different clinical presentation. It is a heterogeneous disease with a complex etiology that still needs more research.

Disclosure of interest

The authors have not supplied their declaration of competing interest.