Epidemiology of older age bipolar disorder

Older adults with bipolar disorder are expected to increase in numbers in the future, will likely require more health services than their same-aged peers, and have been understudied as a group. While prevalence rates of older age bipolar disorder (OABD) are low in community samples, older adults with bipolar disorder are frequently seen in treatment settings. Individuals can present with new-onset mania throughout the life span. Older adults presenting with mania have been thought to comprise two clinically significant subgroups: those with early-onset bipolar disorder (EOBD) and those with late-onset bipolar disorder (LOBD). Individuals with late-onset bipolar illness are more likely to be women, less likely to have a family history of bipolar disorder, and more likely to have cerebrovascular risk factors or disease. The symptoms of bipolar disorder do not typically attenuate over time and older patients may experience more frequent periods of illness with less time spent in a euthymic state. Older adults with bipolar disorder are at increased risk for functional decline and overall morbidity and mortality.