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Biomarkers of Bipolar Disorder in Late Life: An Evidence-Based Systematic Review

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Abstract

Purpose of Review

Review the current evidence on biomarkers for bipolar disorder in the older adults. We conducted a systematic search of PubMed MEDLINE, PsycINFO, and Web of Science databases using the MeSH search terms "Biomarkers", "Bipolar Disorder", "Aged" and and “Aged, 80 and over”. Studies were included if they met the following criteria: (1) the mean age of the study population was 50 years old or older, (2) the study included patients with bipolar disorder, and (3) the study examined one type of biomarkers or more including genetic, neuroimaging, and biochemical biomarkers. Reviews, case reports, studies not in English and studies for which no full text was available were excluded. A total of 26 papers were included in the final analysis.

Recent Findings

Genomic markers of bipolar disorder in older adults highlighted the implication of serotonin metabolism, while the expression of genes involved in angiogenesis was dysregulated. Peripheral blood markers were mainly related with low grade inflammation, axonal damage, endothelial dysfunction, and the dysregulation of the HPA axis. Neuroanatomical markers reflected a dysfunction of the frontal cortex, a loss of neurones in the anterior cingulate cortex and a reduction of the hippocampal volume (in patients older than 50 years old). While not necessarily limited to older adults, some of them may be useful for differential diagnosis (neurofilaments), disease staging (homocysteine, BDNF) and the monitoring of treatment outcomes (matrix metalloproteinases).

Summary

Our review provides a comprehensive overview of the current evidence on biomarkers for bipolar disorder in the older adults. The identification of biomarkers may aid in the diagnosis, treatment selection, and monitoring of bipolar disorder in older adults, ultimately leading to improved outcomes for this population. Further research is needed to validate and further explore the potential clinical utility of biomarkers in this population.

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Author information

Authors and Affiliations

  1. PSNREC, Univ Montpellier, INSERM, CHU de Montpellier, Montpellier, France

    R. Chancel & Ph. Courtet

  2. Department of Emergency Psychiatry and Acute Care, Lapeyronie Hospital, CHU Montpellier, Montpellier, France

    R. Chancel & Ph. Courtet

  3. Department of Psychiatry, Nimes University Hospital, Nimes, France

    J. Lopez-Castroman

  4. Department of Signal Theory and Communications, Carlos III University, Madrid, Spain

    J. Lopez-Castroman

  5. Institut de Génomique Fonctionnelle, University of Montpellier, CNRS-INSERM, Montpellier, France

    J. Lopez-Castroman

  6. Centro de Investigación Biomédica en Red de Salud Mental, Madrid, Spain

    J. Lopez-Castroman

  7. Instituto de Investigación Sanitaria Fundación Jiménez Díaz, Madrid, Spain

    E. Baca-Garcia & I. Conejero

  8. Department of Psychiatry, Hospital Universitario Rey Juan Carlos, Móstoles, Madrid, Spain

    E. Baca-Garcia

  9. Universidad Autónoma de Madrid, Madrid, Spain

    E. Baca-Garcia & I. Conejero

  10. Department of Psychiatry, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain

    E. Baca-Garcia & I. Conejero

  11. Department of Psychiatry, Hospital Universitario Central de Villalba, Madrid, Spain

    E. Baca-Garcia

  12. Department of Psychiatry, Hospital Universitario Infanta Elena, Valdemoro, Madrid, Spain

    E. Baca-Garcia

  13. Universidad Católica del Maude, Talca, Chile

    E. Baca-Garcia

  14. CIBERSAM, Instituto de Salud Carlos III, Madrid, Spain

    E. Baca-Garcia

  15. Department of Psychiatry, University of Santiago de Compostela, Santiago de Compostela, Spain

    R. Mateos Alvarez

  16. Psychogeriatric Unit, CHUS University Hospital, Santiago de Compostela, Spain

    R. Mateos Alvarez

  17. Department of Psychiatry, CHU Nîmes, PSNREC, INSERM, University of Montpellier, Nîmes, France

    I. Conejero

  18. Pôle de psychiatrie, CHU Nîmes, Rue du Professeur Robert Debré, 30900, Nîmes, France

    I. Conejero

Authors
  1. R. Chancel
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  2. J. Lopez-Castroman
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  3. E. Baca-Garcia
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  4. R. Mateos Alvarez
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  5. Ph. Courtet
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  6. I. Conejero
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Corresponding author

Correspondence to I. Conejero.

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R. Chancel, J. Lopez-Castroman, E. Baca-Garcia, R. Mateos Alvarez, Ph. Courtet, and I. Conejero each declare no potential conflicts of interest.

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Chancel, R., Lopez-Castroman, J., Baca-Garcia, E. et al. Biomarkers of Bipolar Disorder in Late Life: An Evidence-Based Systematic Review. Curr Psychiatry Rep 26, 78–103 (2024). https://doi.org/10.1007/s11920-024-01483-7

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