Bipolar symptoms, somatic burden and functioning in older‐age bipolar disorder: A replication study from the global aging & geriatric experiments in bipolar disorder database (GAGE‐BD) project

Author:

Sajatovic Martha1ORCID,Rej Soham2ORCID,Almeida Osvaldo P.3ORCID,Altinbas Kursat4,Balanzá‐Martínez Vicent5,Barbosa Izabela G.6,Beunders Alexandra J. M.7,Blumberg Hilary P.8,Briggs Farren B. S.9,Dols Annemiek1011ORCID,Forester Brent P.1213,Forlenza Orestes V.14,Gildengers Ariel G.15ORCID,Jimenez Esther16,Klaus Federica17,Lafer Beny18,Mulsant Benoit19,Mwangi Benson20,Nunes Paula Villela18,Olagunju Andrew T.21ORCID,Oluwaniyi Stephen22,Orhan Melis23,Patrick Regan E.1213,Radua Joaquim24,Rajji Tarek25,Sarna Kaylee26,Schouws Sigfried27,Simhandl Christian28,Sekhon Harmehr29,Soares Jair C.30,Sutherland Ashley N.1731,Teixeira Antonio L.3032,Tsai Shangying33,Vidal‐Rubio Sonia34,Vieta Eduard16,Yala Joy26,Eyler Lisa T.1731ORCID

Affiliation:

1. Case Western Reserve University School of Medicine University Hospitals Cleveland Medical Center Cleveland Ohio USA

2. Jewish General Hospital/Lady Davis Hospital McGill University Montreal Québec Canada

3. University of Western Australia Perth Western Australia Australia

4. Selçuk University Medical Faculty Department of Psychiatry Mazhar Osman Mood Clinic Konya Turkey

5. Teaching Unit of Psychiatry and Psychological Medicine Department of Medicine University of Valencia CIBERSAM Valencia Spain

6. Mental Health Department Medicine School Minas Gerais University Belo Horizonte Brazil

7. GGZ inGeest Amsterdam UMC Vrije Universiteit Amsterdam Psychiatry, Amsterdam Public Health Research Institute Amsterdam The Netherlands

8. Department of Psychiatry Yale School of Medicine New Haven Connecticut USA

9. Department of Population and Quantitative Health Sciences Case Western Reserve University School of Medicine Cleveland Ohio USA

10. Amsterdam UMC VU University, Amsterdam Neuroscience Amsterdam The Netherlands

11. Department of Psychiatry UMC Utrecht Brain Center University Medical Center Utrecht Utrecht The Netherlands

12. Division of Geriatric Psychiatry McLean Hospital Belmont Massachusetts USA

13. Harvard Medical School Boston Massachusetts USA

14. Laboratory of Neuroscience (LIM‐27) Department and Institute of Psychiatry HCFMUSP Faculdade de Medicina da Universidade de São Paulo São Paulo Brazil

15. Department of Psychiatry University of Pittsburgh School of Medicine Pittsburgh Pennsylvania USA

16. Bipolar and Depressive Disorders Unit Hospital Clinic University of Barcelona IDIBAPS CIBERSAM ISCIII Barcelona Barcelona Catalonia Spain

17. Department of Psychiatry University of California San Diego California USA

18. Department of Psychiatry University of São Paulo Medical School São Paulo Brazil

19. Department of Psychiatry University of Toronto Center for Addiction & Mental Health Toronto Ontario Canada

20. Department of Psychiatry and Behavioral Sciences McGovern Medical School UTHealth Houston Houston Texas USA

21. Department of Psychiatry and Behavioral Neurosciences McMaster University/St Joseph's Healthcare Hamilton Hamilton Ontario Canada

22. Lagos Federal Neuropsychiatry Hospital Lagos Nigeria

23. Department of Clinical Psychology Leiden University Leiden The Netherlands

24. Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS) CIBERSAM Instituto de Salud Carlos III University of Barcelona Barcelona Spain

25. Department of Psychiatry Toronto Dementia Research Alliance University of Toronto Toronto Ontario Canada

26. Case Western Reserve University School of Medicine Cleveland Ohio USA

27. GGZ inGeest Amsterdam UMC VU Medical Center Amsterdam The Netherlands

28. Medical Faculty Bipolar Center Wiener Neustadt Sigmund Freud University Vienna Wien Austria

29. Department of Psychiatry Jewish General Hospital/Lady Davis Institute McGill University Montreal Quebec Canada

30. Department of Psychiatry and Behavioral Sciences University of Texas/McGovern Medical School Houston Texas USA

31. Desert‐Pacific Mental Illness Research Education and Clinical Center VA San Diego Healthcare System San Diego California USA

32. Faculdade Santa Casa BH Belo Horizonte Brazil

33. Department of Psychiatry School of Medicine College of Medicine Taipei Medical University Taipei Taiwan

34. Psychiatry Service Hospital de la Ribera Valencia Spain

Abstract

AbstractObjectivesThe Global Aging & Geriatric Experiments in Bipolar Disorder Database (GAGE‐BD) project pools archival datasets on older age bipolar disorder (OABD). An initial Wave 1 (W1; n = 1369) analysis found both manic and depressive symptoms reduced among older patients. To replicate this finding, we gathered an independent Wave 2 (W2; n = 1232, mean ± standard deviation age 47.2 ± 13.5, 65% women, 49% aged over 50) dataset.Design/MethodsUsing mixed models with random effects for cohort, we examined associations between BD symptoms, somatic burden and age and the contribution of these to functioning in W2 and the combined W1 + W2 sample (n = 2601).ResultsCompared to W1, the W2 sample was younger (p < 0.001), less educated (p < 0.001), more symptomatic (p < 0.001), lower functioning (p < 0.001) and had fewer somatic conditions (p < 0.001). In the full W2, older individuals had reduced manic symptom severity, but age was not associated with depression severity. Age was not associated with functioning in W2. More severe BD symptoms (mania p ≤ 0.001, depression p ≤ 0.001) were associated with worse functioning. Older age was significantly associated with higher somatic burden in the W2 and the W1 + W2 samples, but this burden was not associated with poorer functioning.ConclusionsIn a large, independent sample, older age was associated with less severe mania and more somatic burden (consistent with previous findings), but there was no association of depression with age (different from previous findings). Similar to previous findings, worse BD symptom severity was associated with worse functioning, emphasizing the need for symptom relief in OABD to promote better functioning.

Funder

National Institutes of Health

National Center for Advancing Translational Sciences

International Society for Bipolar Disorders

Clinical and Translational Science Collaborative of Cleveland, School of Medicine, Case Western Reserve University

Publisher

Wiley

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