@article{9dabeb8307cd4d1ab9e7866dad9b49ff,
title = "Bipolar symptoms, somatic burden, and functioning in older-age bipolar disorder: Analyses from the Global Aging & Geriatric Experiments in Bipolar Disorder Database project",
abstract = "Objective: Literature on older-age bipolar disorder (OABD) is limited. This first-ever analysis of the Global Aging & Geriatric Experiments in Bipolar Disorder Database (GAGE-BD) investigated associations among age, BD symptoms, comorbidity, and functioning. Methods: This analysis used harmonized, baseline, cross-sectional data from 19 international studies (N = 1377). Standardized measures included the Young Mania Rating Scale (YMRS), Hamilton Depression Rating Scale (HAM-D), Montgomery-Asberg Depression Rating Scale (MADRS), and Global Assessment of Functioning (GAF). Results: Mean sample age was 60.8 years (standard deviation [SD] 12.2 years), 55% female, 72% BD I. Mood symptom severity was low: mean total YMRS score of 4.3 (SD 5.4) and moderate-to-severe depression in only 22%. Controlled for sample effects, both manic and depressive symptom severity appeared lower among older individuals (p's < 0.0001). The negative relationship between older age and symptom severity was similar across sexes, but was stronger among those with lower education levels. GAF was mildly impaired (mean =62.0, SD = 13.3) and somatic burden was high (mean =2.42, SD = 1.97). Comorbidity burden was not associated with GAF. However, higher depressive (p < 0.0001) and manic (p < 0.0001) symptoms were associated with lower GAF, most strongly among older individuals. Conclusions: Findings suggest an attenuation of BD symptoms in OABD, despite extensive somatic burden. Depressive symptom severity was strongly associated with worse functioning in older individuals, underscoring the need for effective treatments of BD depression in older people. This international collaboration lays a path for the development of a better understanding of aging in BD.",
keywords = "aging, bipolar disorder, depression, functioning, mania, medical burden",
author = "Martha Sajatovic and Annemiek Dols and Soham Rej and Almeida, {Osvaldo P} and Beunders, {Alexandra J M} and Blumberg, {Hilary P} and Briggs, {Farren B S} and Forester, {Brent P} and Patrick, {Regan E} and Forlenza, {Orestes V} and Ariel Gildengers and Esther Jimenez and Eduard Vieta and Benoit Mulsant and Sigfried Schouws and Nadine Paans and Sergio Strejilevich and Ashley Sutherland and Shangying Tsai and Betsy Wilson and Eyler, {Lisa T}",
note = "Funding Information: This project was supported by the International Society for Bipolar Disorders (ISBD) Bowden Massey Strategic Research Initiative; US National Institute of Mental Health (R01MH070902, R01MH113230, R01MH084921); Pfizer; Glaxo Smith Kline; Merck; National Health and Medical Research Council of Australia; National Institute for Biomarker Research in Neuropsychiatry, INBION (FAPESP 14/50873-3; 2016/01302-9 and CNPq 465412/2014-9); Associa{\c c}{\~a}o Beneficente Alzira Denise Hertzog da Silva (ABADHS); Canadian Institutes for Health Research, grant 200017; Ministry of Science and Technology, Taiwan; Spanish Ministry of Science and Innovation (PI15/00283, PI18/00805) integrated into the Plan Nacional de I+D+I and co-financed by the ISCIII-Subdirecci{\'o}n General de Evaluaci{\'o}n and the Fondo Europeo de Desarrollo Regional (FEDER); the Instituto de Salud Carlos III; the CIBER of Mental Health (CIBERSAM); the Secretaria d{\textquoteright}Universitats i Recerca del Departament d{\textquoteright}Economia i Coneixement (2017 SGR 1365); the CERCA Programme; and the Departament de Salut de la Generalitat de Catalunya for the PERIS grant SLT006/17/00357. This publication's contents are solely the responsibility of the authors and do not necessarily represent the official views of ISBD. The ISBD is a 401c3 non-profit organization whose mission is to foster international collaboration in education and research. For more information, visit www.isbd.org and www.gage-bd.org. The authors thank the following people: Leon Flicker, Graeme J. Hankey, Bu B. Yeap, Jonathan Golledge, Melis Orhan, Nicole Korten, Tokie Kemp, Lejla Colic PhD, Luca Villa PhD, Susan Quatrano, Miranda Skurla, Patrick Monette, Beny Lafer, James Emanuel, Daniel M. Blumberger, and Tarek K. Rajji. Funding Information: This project was supported by the International Society for Bipolar Disorders (ISBD) Bowden Massey Strategic Research Initiative; US National Institute of Mental Health (R01MH070902, R01MH113230, R01MH084921); Pfizer; Glaxo Smith Kline; Merck; National Health and Medical Research Council of Australia; National Institute for Biomarker Research in Neuropsychiatry, INBION (FAPESP 14/50873‐3; 2016/01302‐9 and CNPq 465412/2014‐9); Associa{\c c}{\~a}o Beneficente Alzira Denise Hertzog da Silva (ABADHS); Canadian Institutes for Health Research, grant 200017; Ministry of Science and Technology, Taiwan; Spanish Ministry of Science and Innovation (PI15/00283, PI18/00805) integrated into the Plan Nacional de I+D+I and co‐financed by the ISCIII‐Subdirecci{\'o}n General de Evaluaci{\'o}n and the Fondo Europeo de Desarrollo Regional (FEDER); the Instituto de Salud Carlos III; the CIBER of Mental Health (CIBERSAM); the Secretaria d{\textquoteright}Universitats i Recerca del Departament d{\textquoteright}Economia i Coneixement (2017 SGR 1365); the CERCA Programme; and the Departament de Salut de la Generalitat de Catalunya for the PERIS grant SLT006/17/00357. Publisher Copyright: {\textcopyright} 2021 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.",
year = "2022",
month = mar,
doi = "10.1111/bdi.13119",
language = "English",
volume = "24",
pages = "195--206",
journal = "Bipolar Disorders",
issn = "1398-5647",
publisher = "Blackwell Munksgaard",
number = "2",
}