Older men with bipolar disorder diagnosed in early and later life: physical health morbidity and general hospital service use

Almeida, Osvaldo P., Hankey, Graeme J., Yeap, Bu B., Golledge, Jonathan, and Flicker, Leon (2018) Older men with bipolar disorder diagnosed in early and later life: physical health morbidity and general hospital service use. Journal of Affective Disorders, 241. pp. 269-274.

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View at Publisher Website: http://doi.org/10.1016/j.jad.2018.08.035
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Abstract

Background: Bipolar disorder (BD) has been associated with greater health morbidity burden, but it is unclear if this association is affected by age at the time of diagnosis and how this might impact on the use of general hospital services.

Methods: Cross-sectional study investigating the prevalence of common medical morbidities among participants with early (EOBD) and late onset diagnosis of BD (LOBD - age at diagnosis >= 60 years) derived from a community-representative sample of 37,183 men aged 65-85 years. Cohort study over a follow up period of up to 17.7 years investigating the hazard of general hospital use among older men associated with EOBD and LOBD taking into account age and prevalent medical morbidities.

Results: 250 older men had a recorded diagnosis of BD, 75 of whom had LOBD. Diabetes, stroke and diseases of the respiratory and digestive systems were more frequent in men with than without BD. There were no differences in the distribution of medical morbidities between men with EOBD and LOBD. The adjusted hazard ratio (HR) of contact with general hospital services was significantly higher among men with EOBD (HR = 1.33; 95%CI = 1.14, 1.54) and LOBD (HR = 1.27, 95%CI = 1.06, 1.51) compared with older men without BD. Older men with EOBD had the highest number of contacts with general hospital services during follow up, although men with EOBD and LOBD did not differ in the number of contacts due to episodes of mania or depression. The medical reasons for contact with general hospital services of men with EOBD and LOBD overlapped but were not identical.

Conclusions: Older men with BD experience greater health morbidity than men without BD. Older men with BD access hospital services for the management of physical morbidities earlier and more frequently than men without BD. Age at the time of diagnosis of BD has limited impact on the risk of contact with general medical services, although subtle differences in the physical morbidity of men with EOBD and LOBD warrant further investigation.

Item ID: 55611
Item Type: Article (Research - C1)
ISSN: 1573-2517
Keywords: bipolar disorder, mania, elderly, morbidity, diabetes, stroke, cancer, renal disease, dementia, mortality, health care
Copyright Information: Copyright © 2018 Elsevier B.V. All rights reserved.
Funders: National Health and Medical Research Council (NHMRC)
Projects and Grants: NHMRC 279408, NHMRC 379600, NHMRC 403963, NHMRC 513823, NHMRC 540403, NHMRC 540504, NHMRC 540405, NHMRC 634492, NHMRC 1021416, NHMRC 1045710, NHMRC 1060557
Date Deposited: 19 Sep 2018 07:51
FoR Codes: 11 MEDICAL AND HEALTH SCIENCES > 1103 Clinical Sciences > 110399 Clinical Sciences not elsewhere classified @ 100%
SEO Codes: 92 HEALTH > 9201 Clinical Health (Organs, Diseases and Abnormal Conditions) > 920103 Cardiovascular System and Diseases @ 100%
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