Bipolar symptoms, somatic burden, and functioning in older-age bipolar disorder: Analyses from the Global Aging & Geriatric Experiments in Bipolar Disorder Database project

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Sajatovic, Martha ^[1] ; Dols, Annemiek ^[2] ; Rej, Soham ^[3] ; Almeida, Osvaldo P. ^[4] ; Beunders, Alexandra J. M. ^[2] ; Blumberg, Hilary P. ^[5] ; Briggs, Farren B. S. ^[6] ; Forester, Brent P. ^{[7, 8]} ; Patrick, Regan E. ^[8] ; Forlenza, V, Orestes ; Gildengers, Ariel ^[9] ; Jimenez, Esther ^[10] ; Vieta, Eduard ^[10] ; Mulsant, Benoit ^[11] ; Schouws, Sigfried ^[12] ; Paans, Nadine ^[13] ; Strejilevich, Sergio ^[14] ; Sutherland, Ashley ^[15] ; Tsai, Shangying ^[16] ; Wilson, Betsy ^[17] ; Eyler, Lisa T. ^{[15, 18]}

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^[1] Case Western Reserve Univ, Univ Hosp Cleveland, Sch Med, Med Ctr, Cleveland, OH 44106 - USA

^[2] Amsterdam Publ Hlth Res Inst, VU Med Ctr, Amsterdam Neurosci, Amsterdam UMC, GGZ InGeest, Amsterdam - Netherlands

^[3] McGill Univ, Lady Davis Inst, Montreal, PQ - Canada

^[4] Univ Western Australia, Perth, WA - Australia

^[5] Yale Sch Med, Dept Psychiat, New Haven, CT - USA

^[6] Case Western Reserve Univ, Sch Med, Dept Populat & Quantitat Hlth Sci, Cleveland, OH - USA

^[7] Harvard Med Sch, Boston, MA 02115 - USA

^[8] McLean Hosp, Div Geriatr Psychiat, 115 Mill St, Belmont, MA 02178 - USA

^[9] Univ Pittsburgh, Sch Med, Dept Psychiat, Pittsburgh, PA - USA

^[10] Univ Barcelona, Hosp Clin, Bipolar & Depress Disorders Unit, IDIBAPS, CIBERSAM, Barcelona - Spain

^[11] Univ Toronto, Ctr Addict & Mental Hlth, Dept Psychiat, Toronto, ON - Canada

^[12] Vrije Univ Amsterdam Med Ctr, Amsterdam UMC, GGZ InGeest, Amsterdam - Netherlands

^[13] Vrije Univ Amsterdam Med Ctr, Amsterdam Publ Hlth Res Inst, Amsterdam UMC, GGZ InGeest, Amsterdam - Netherlands

^[14] Assistance & Res Affect Disorders, Buenos Aires, DF - Argentina

^[15] Univ Calif San Diego, Dept Psychiat, San Diego, CA 92103 - USA

^[16] Taipei Med Univ, Coll Med, Sch Med, Dept Psychiat, Taipei - Taiwan

^[17] Case Western Reserve Univ, Sch Med, Cleveland, OH - USA

^[18] VA San Diego Healthcare Syst, Desert Pacific Mental Illness Res Educ & Clin Ctr, San Diego, CA - USA

• Tipo de documento: Artigo Científico
• Fonte: BIPOLAR DISORDERS; AUG 2021.
• Citações Web of Science: 0

Resumo

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. (AU)

• Processo FAPESP: 16/01302-9 - Identificação das vias direta e indireta da inibição da glicogênio sintase kinase 3B pelo lítio em cultura de neurônios
• Beneficiário: Vanessa de Jesus Rodrigues de Paula
• Modalidade de apoio: Bolsas no Brasil - Pós-Doutorado
• Processo FAPESP: 14/50873-3 - INCT 2014: Instituto Nacional de Biomarcadores em Neuropsiquiatria (INBioN)
• Beneficiário: Wagner Farid Gattaz
• Modalidade de apoio: Auxílio à Pesquisa - Temático