TY - JOUR
T1 - Symptom Severity Mixity in Older-Age Bipolar Disorder
T2 - Analyses From the Global Aging and Geriatric Experiments in Bipolar Disorder Database (GAGE-BD)
AU - Eyler, Lisa T.
AU - Briggs, Farren B.S.
AU - Dols, Annemiek
AU - Rej, Soham
AU - Almeida, Osvaldo P.
AU - Beunders, Alexandra J.M.
AU - Blumberg, Hilary P.
AU - Forester, Brent P.
AU - Patrick, Regan E.
AU - Forlenza, Orestes V.
AU - Gildengers, Ariel
AU - Jimenez, Esther
AU - Vieta, Eduard
AU - Mulsant, Benoit H.
AU - Schouws, Sigfried
AU - Paans, Nadine P.G.
AU - Strejilevich, Sergio
AU - Sutherland, Ashley
AU - Tsai, Shangying
AU - Sajatovic, Martha
N1 - 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 , R01MH11323 0, 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); Associação 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-Subdirección General de Evaluación and the Fondo Europeo de Desarrollo Regional (FEDER); the Instituto de Salud Carlos III; the CIBER of Mental Health (CIBERSAM); the Secretaria d'Universitats i Recerca del Departament d'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:
© 2022
PY - 2022/10
Y1 - 2022/10
N2 - Objective: Some individuals with bipolar disorder (BD) experience manic and depressive symptoms concurrently, but data are limited on symptom mixity in older age bipolar disorder (OABD). Using the Global Aging & Geriatric Experiments in Bipolar Disorder Database, we characterized mixity in OABD and associations with everyday function. Methods: The sample (n = 805), from 12 international studies, included cases with both mania and depression severity ratings at a single timepoint. Four mixity groups were created: asymptomatic (A), mixed (Mix), depressed only (Dep), and manic only (Man). Generalized linear mixed models used mixity group as the predictor variable; cohort was included as a random intercept. Everyday function was assessed with the Global Assessment of Functioning score. Results: Group proportions were Mix (69.6%; n = 560), followed by Dep (18.4%; n = 148), then A (7.8%; n = 63), then Man (4.2%; n= 34); levels of depression and mania were similar in Mix compared to Dep and Man, respectively. Everyday function was lowest in Mix, highest in A, and intermediate in Man and Dep. Within Mix, severity of depression was the main driver of worse functioning. Groups differed in years of education, with A higher than all others, but did not differ by age, gender, employment status, BD subtype, or age of onset. Conclusions: Mixed features predominate in a cross-sectional, global OABD sample and are associated with worse everyday function. Among those with mixed symptoms, functional status relates strongly to current depression severity. Future studies should include cognitive and other biological variables as well as longitudinal designs to allow for evaluation of causal effects.
AB - Objective: Some individuals with bipolar disorder (BD) experience manic and depressive symptoms concurrently, but data are limited on symptom mixity in older age bipolar disorder (OABD). Using the Global Aging & Geriatric Experiments in Bipolar Disorder Database, we characterized mixity in OABD and associations with everyday function. Methods: The sample (n = 805), from 12 international studies, included cases with both mania and depression severity ratings at a single timepoint. Four mixity groups were created: asymptomatic (A), mixed (Mix), depressed only (Dep), and manic only (Man). Generalized linear mixed models used mixity group as the predictor variable; cohort was included as a random intercept. Everyday function was assessed with the Global Assessment of Functioning score. Results: Group proportions were Mix (69.6%; n = 560), followed by Dep (18.4%; n = 148), then A (7.8%; n = 63), then Man (4.2%; n= 34); levels of depression and mania were similar in Mix compared to Dep and Man, respectively. Everyday function was lowest in Mix, highest in A, and intermediate in Man and Dep. Within Mix, severity of depression was the main driver of worse functioning. Groups differed in years of education, with A higher than all others, but did not differ by age, gender, employment status, BD subtype, or age of onset. Conclusions: Mixed features predominate in a cross-sectional, global OABD sample and are associated with worse everyday function. Among those with mixed symptoms, functional status relates strongly to current depression severity. Future studies should include cognitive and other biological variables as well as longitudinal designs to allow for evaluation of causal effects.
KW - Bipolar disorder
KW - depression
KW - elderly
KW - geriatric
KW - mania
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U2 - 10.1016/j.jagp.2022.03.007
DO - 10.1016/j.jagp.2022.03.007
M3 - Article
C2 - 35637088
AN - SCOPUS:85130354945
SN - 1064-7481
VL - 30
SP - 1096
EP - 1107
JO - American Journal of Geriatric Psychiatry
JF - American Journal of Geriatric Psychiatry
IS - 10
ER -