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Tijdschrift voor Psychiatrie 59 (2017) 11, 693 - 701

Essay

Older patients with a bipolar disorder, a distinctive group

A. Dols, S. Schouws

background The number of older adults with bipolar disorders is growing and warrants a specific approach. Recommendations, as in the current guideline, are mostly based on research in samples with younger patients or from the United States, as best available evidence.
aim To raise awareness of the limitations of the current guidelines for older adults with bipolar disorder.
method We present a selection of Dutch studies on older adults with bipolar disorder and compared these findings with research done in younger patients or older patients from the United States.
results Psychiatric comorbidity is relatively rare, somatic comorbidity is more frequent as is medication use. Cognition is impaired, but stable after 5 years of follow-up. Social functioning is associated with cognition. Less than half of the older adults with bipolar disorders reported unmet needs, mostly on company and daily activities.
conclusion Dutch research on older adults with bipolar disorder confirms the differences with younger patients with bipolar disorder and their American peers. Recommendations can’t be extrapolated to older adults with bipolar disorders. More research is needed to provide evidence based guidelines for this special population.

keywords bipolar disorder, elderly, guidelines, treatment