Experts have found that bipolar disorder in older people is often underestimated and difficult to diagnose due to other comorbid conditions.
Hospitalisations of older people with bipolar disorder are, for the most part, urgent in nature, involve long stays and are associated with high readmission rates. This is one of the conclusions of a study led by the RISE-Health Research Unit, which sought to understand hospitalisations of older people with bipolar disorder at a national level.
According to the authors, who analysed a total of 4,801 hospitalisations between 2008 and 2015, “as populations age, bipolar disorder is associated with other conditions that arise or worsen with age, which will lead to increased demand for healthcare and challenges in managing psychiatric and non-psychiatric comorbidities”.
“Bipolar disorder is a – severe – mood disorder. The common perception of bipolar disorder that we hear in everyday conversation mistakenly attributes rapid mood swings to these patients. “When we talk about mood changes in bipolar disorder, we are referring to mood fluctuations that can last for weeks or even months, characterised by depressive or (hypo)manic episodes,” explains Manuel Gonçalves Pinho, a researcher at RISE-Health (RISE-Health/FMUP).
According to the specialist from RISE-Health and the Faculty of Medicine of the University of Porto (FMUP), older adults with bipolar disorder have more medical comorbidities, namely cardiovascular disease, diabetes, dementia and chronic lung disease, which, in turn, “are important to consider when managing these patients’ treatment, not least because some of the medications can affect other non-psychiatric conditions, such as kidney and thyroid disease”.
Through the study published in the International Journal of Geriatric Psychiatry, the experts found that bipolar disorder in older adults is often underestimated and difficult to diagnose, due to its overlap with cognitive impairments and other neurological conditions, and they argued for the need for measures to address the prevalence and consequences of this condition.
“A diagnosis of bipolar disorder is not a death sentence. However, once patients are diagnosed, we must ensure they have access to appropriate healthcare and know how to recognise the signs of the condition becoming uncontrolled, whether these are depressive, manic or hypomanic episodes. The latter are often characterised by high energy levels, elevated mood, very high self-esteem, excessive spending and, in some cases, delusions,” explains the psychiatrist.
The scientific paper “Bipolar Disorder Hospitalisation in Older Adults: A Nationwide Retrospective Study” was authored by Manuel Gonçalves-Pinho, Daniela Soberano, Lia Fernandes, Alberto Freitas and Ana Rita Ferreira (RISE-Health/FMUP).