Bipolar Disorder and the Elderly

The difficulty of treating the elderly diagnosed with bipolar disorder (BD) primarily relates to the scarcity of research on this population with it. Another mitigating factor is the medication changes/additions elderly require and how they may interact with medication for bipolar disorder. Research has shown the importance of maintaining patients on low levels of medication and how medication changes can create difficulties.

One study indicates that as many as 10 percent of all BD cases develop after the age of 50. This later onset also has a greater likelihood of relapse than an earlier onset. Early stages of dementia can include symptoms like BD. Generally, the elderly BD patients metabolize treatment drugs differently. This often produces a narrowing of the therapeutic effect of the medications. Medication doses for elderly patients with BD are generally one half to one third the dose of other patients. Elderly patients with BD tend to have longer hospital stays than younger patients and tend to use outpatient services more. Lithium, the most widely used medication for patients with BD, presents different challenges when taken by the elderly. Although it is still an effective treatment, it has been found to have double the half-life in the elderly as compared to the general population. Clinical research shows that elderly patients require a lower dose of lithium because of this feature.

Statistics from the National Institute of Mental Health show that BD has been clinically diagnosed in 0.1 percent of people over 65-years-old. This compares with 1.8 percent of BD patients in younger demographics.