Medical and psychiatric comorbidities among elderly individuals with bipolar disorder: a literature review.

INTRODUCTION

The common comorbid conditions that accompany late-life bipolar disorder (BD) have not been well studied. This is a literature review on psychiatric and medical comorbidities among elderly individuals with BD.

METHODS

A focused literature review searched PubMed. Inclusion criteria were original research reports, in English, until June 2009, specifically focused on medical and psychiatric comorbidities in BD individuals over the age of 50.

RESULTS

A limited number of studies were identified. Most involved small samples (n < 100). Metabolic syndrome, respiratory and cardiovascular conditions, and endocrine abnormalities are common, with patients having an average of 3 to 4 medical comorbid conditions. Approximately 4.5% to 19% of elderly individuals with BD have dementia. Rates of psychiatric comorbidity appear lower than in younger BD populations, with the most common concurrent psychiatric illnesses being anxiety and substance use disorders. Rates of comorbid medical conditions appear similar to rates among geriatric patients without BD.

CONCLUSIONS

Elderly individuals with BD are burdened by multiple concomitant medical disorders. In contrast to the elevated rates of medical comorbidity, rates of psychiatric comorbidity appear lower in elderly individuals with BD than in younger populations with BD. Greater awareness of concurrent medical conditions might help inform coordinated care that considers both mental and physical health among geriatric patients with BD.