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ABSTRACT
Late-onset mania is a rare condition that can he successfully treated but is easily unrecognized and misdiagnosed. When mania manifests against a background of pre-existing cognitive impairment in an elderly patient, it may be difficult to distinguish from agitated states occurring in the course of dementia or delirium. Secondary mania occurs in the elderly as result of a variety of medical and/or pharmacological antecedents. Primary mania occurs as a phase of manic-depressive illness similar to that seen in young adults.
Two elderly patients who presented with first episode mania in late life are described, and the clinical, diagnostic and management problems are discussed. In both cases there were no significant abnormalities on laboratory tests or CAT scan. In one patient there was cognitive impairment. Both patients responded to valproic acid.