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Update on the Epidemiology, Diagnosis, and Treatment of Mania in Older-Age Bipolar Disorder

  • Peijun Chen
  • Annemiek Dols
  • Soham Rej
  • Martha SajatovicEmail author
Geriatric Disorders (W McDonald, Section Editor)
Part of the following topical collections:
  1. Topical Collection on Geriatric Disorders

Abstract

Purpose of Review

The population over age 60 is growing more rapidly than the general population. Given the projected increase and need for data that can inform treatment, this review provides a brief description of newer publications focused on mania in older-age bipolar disorder (OABD), including epidemiology, diagnosis, and treatments.

Recent Findings

Age cutoffs to define OABD range from 50 to 65 years. OABD clinical presentation and course of illness is highly variable, often characterized by mood episode recurrence, medical comorbidity, cognitive deficits, and impaired functioning. There is little pharmacotherapy data on mania in OABD. Lithium and valproate have been tested in a single randomized controlled trial and there is data of more limited quality with other compounds.

Summary

Treating OABD is challenging due to medical complexity, comorbidity, diminished tolerance to treatment, and a limited evidence base. More data is needed to keep pace with clinical demand.

Keywords

Mania Elderly Geriatric Bipolar disorder Manic-depressive disorder Mood stabilizers 

Notes

Compliance with Ethical Standards

Conflict of Interest

Peijun Chen, Annemiek Dols, and Soham Rej each declare no potential conflicts of interest.

Martha Sajatovic has received grant support from Alkermes, Janssen, Pfizer, and Merck and royalties from Springer Press, Johns Hopkins University Press, and Oxford Press and served as consultant for Bracket, Pfizer, Otsuka, Sunovion, Neurocrine, Supernus, and Health Analytics.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

References

Papers of particular interest, published recently, have been highlighted as: • Of importance

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Copyright information

© Springer Science+Business Media, LLC 2017

Authors and Affiliations

  • Peijun Chen
    • 1
  • Annemiek Dols
    • 2
  • Soham Rej
    • 3
    • 4
  • Martha Sajatovic
    • 5
    Email author
  1. 1.Department of Psychiatry, Case Western Reserve University School of MedicineLouis Stokes Veterans Administration Medical CenterClevelandUSA
  2. 2.Department of Old Age Psychiatry, GGZ inGeestVU University Medical CenterAmsterdamThe Netherlands
  3. 3.Department of PsychiatryUniversity of TorontoTorontoCanada
  4. 4.Jewish General Hospital/Lady Davis InstituteMcGill UniversityQCCanada
  5. 5.Departments of Psychiatry and of Neurology, Case Western Reserve University School of MedicineUniversity Hospitals Cleveland Medical CenterClevelandUSA

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