Physical comorbidities of older age bipolar disorder (OABD) patients: A global replication analysis of prevalence and sex differences

Gen Hosp Psychiatry. 2024 Sep-Oct:90:6-11. doi: 10.1016/j.genhosppsych.2024.06.004. Epub 2024 Jun 12.

Abstract

Objectives: To compare the prevalence of physical morbidities between older aged patients with bipolar disorder (OABD) and non-psychiatric comparisons (NC), and to analyze sex differences in prevalence.

Methods: OABD was defined as bipolar disorder among adults aged ≥50 years. Outcomes analyzed were the prevalence of diseases affecting the cardiovascular, respiratory, gastrointestinal, genitourinary, renal, musculoskeletal, and endocrine systems. The analysis used cross-sectional data of OABD participants (n = 878; mean age 60.9 ± 8.0 years, n = 496 (56%) women) from the collaborative Global Aging & Geriatric Experiments in Bipolar Disorder (GAGE-BD) dataset and NC participants recruited at the same sites (n = 355; mean age 64.4 ± 9.7 years, n = 215 (61%) women).

Results: After controlling for sex, age, education, and smoking history, the OABD group had more cardiovascular (odds ratio [95% confidence interval]: 2.12 [1.38-3.30]), renal (5.97 [1.31-43.16]), musculoskeletal (2.09 [1.30-3.43]) and endocrine (1.90 [1.20-3.05]) diseases than NC. Women with OABD had more gastrointestinal (1.56 [0.99-2.49]), genitourinary (1.72 [1.02-2.92]), musculoskeletal (2.64 [1.66-4.37]) and endocrine (1.71 [1.08-2.73]) comorbidities than men with OABD, when age, education, smoking history, and study site were controlled.

Conclusions: This replication GAGE-BD study confirms previous findings indicating that OABD present more physical morbidities than matched comparison participants, and that this health burden is significantly greater among women.

Keywords: Bipolar disorder; Elderly; Geriatrics; Older age bipolar disorder; Physical illness; Psychiatry; Sex differences.

MeSH terms

  • Aged
  • Bipolar Disorder* / epidemiology
  • Cardiovascular Diseases / epidemiology
  • Comorbidity*
  • Cross-Sectional Studies
  • Endocrine System Diseases / epidemiology
  • Female
  • Gastrointestinal Diseases / epidemiology
  • Humans
  • Kidney Diseases / epidemiology
  • Male
  • Middle Aged
  • Musculoskeletal Diseases / epidemiology
  • Prevalence
  • Sex Factors