Abstract
Changing national demographics in concert with growing sophistication in the treatment of bipolar illness have highlighted the need for a better understanding of how bipolar disorder (BD) presents and might be best managed in older adults. Suffering and burden related to illness can be expected to not only affect the older adult with BD, but also families and society at large given the multidimensional effects of the illness on functional status and interpersonal relationships. Clinicians struggling to meet the needs of geriatric patients with BD have few evidence-based studies on which to base treatment decisions, and often must balance treatment of bipolar illness with extensive medical comorbidities. This article will address geriatric BD, including a discussion of epidemiology, illness onset chronology, clinical presentation of BD among geriatric patients, the entity of secondary mania or mania related to identified medical/neurologic pathologies, and treatment and management issues including pharmacotherapies, other biologic treatments and psychosocial interventions. Finally, ongoing challenges and unmet needs with respect to geriatric BD will be discussed.
Financial & competing interests disclosure
M Sajatovic has received grants from GlaxoSmithKline, AstraZeneca and Pfizer, she has been a consultant for Cognition Group, United Biosource Corporation (UBC), ePharma Solutions and Medico, and has received royalties from Lexi Comp, Springer Press, Johns Hopkins University Press and Oxford Press. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.
No writing assistance was utilized in the production of this manuscript.