ABSTRACT
INTRODUCTION Bipolar disorder in older adults is a complex neuropsychiatric syndrome that presents clinicians with both diagnostic and therapeutic challenges. Mania in later life can represent the recurrence of an illness first manifested in adolescence or early adulthood; alternately, it can represent the new onset of a state arising in later life from medical or neurologic causes. In either case, the presentation and treatment of bipolar disorder in later life are frequently complicated by medical comorbidity, especially cardiovascular and cerebrovascular illness (1). Despite clinical lore that bipolar disorder “burns out” with aging, cross-sectional analyses have reported that older adults with bipolar disorder continue to use health services at high rates (2). Unfortunately, there has been little longitudinal study to date on the effects of aging on the course of bipolar disorder.
