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Late-onset bipolar disorder: preliminary results from Sydney

Published online by Cambridge University Press:  24 June 2014

C Wijeratne,
A Olley,
G Mahli and
M Philip
C Wijeratne
Affiliation:
School of Psychiatry, University of New South Wales, Sydney, Australia
A Olley
Affiliation:
School of Psychiatry, University of New South Wales, Sydney, Australia
G Mahli
Affiliation:
Academic Discipline of Psychological Medicine, Northern Clinical School, University of Sydney, New South Wales, AustraliaBlack Dog Institute, Sydney, AustraliaPrince of Wales Medical Research Institute, Sydney, Australia
M Philip
Affiliation:
School of Psychiatry, University of New South Wales, Sydney, Australia
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Abstract

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Information

Type
Abstracts from ‘Brainwaves’— The Australasian Society for Psychiatric Research Annual Meeting 2006, 6–8 December, Sydney, Australia
Information
Acta Neuropsychiatrica , Volume 18 , Issue 6 , December 2006, pp. 311
Copyright
Copyright © 2006 Blackwell Munksgaard

Background:

Previous studies have suggested that there may be bipolar disorder subtypes according to age at onset (AAO), including a late-onset (LO) group with onset in the fifth decade of life. LO presentations may be associated with greater cerebrovascular disease and increased neuropsychological deficits. Different AAO may also explain some of the genetic heterogeneity associated with bipolar disorder.

Method:

We have commenced recruitment of participants aged 40 years and over, with the aim of assessing early-onset bipolar I, late-onset bipolar I and healthy control groups. Assessment tools included the following: sociodemographic and disability questionnaires, SCID, HDRS, YMRS; cerebral magnetic resonance imaging scan; a neuropsychological battery and venepuncture for genetic testing.

Results:

Preliminary results for the first 15 participants with bipolar disorder (mean age 53.9 years, range 46-66 years, 66% women) have shown an average latency of 11 years between the first affective episode and the first episode of mania, and of 17 years before a formal diagnosis of bipolar disorder. There was a high rate of comorbidity with anxiety disorders. Contrary to study hypotheses, the participants tended to be relatively physically healthy with minimal vascular disease burden. Neuropsycho-logical assessment of euthymic participants showed no differences in language and memory, but significant differences in visuospatial organization and self-monitoring tasks.

Conclusions:

These preliminary results suggest deficits in frontal executive dysfunction in this sample of older bipolar participants. The recruitment of a relatively young and ambulatory sample may have led to the finding of minimal vascular disease.