[Bipolar disorders in the elderly].

Usual diagnostic criteria are not suited with the diagnosis of bipolar disorders in the elderly, which then remain often undetected. Bipolar disorders in the elderly are clinically heterogeneous and present with various courses: switch from recurrent depression to mania, early onset or late bipolar disorders. In the elderly, bipolar disorders can take uncommon aspects such as depressive or mixed symptoms, psychosis, mental confusion or dementia. Results from the literature devoted to the evolution of bipolar disorders during life or in terms of age at onset are often contradictory. The prognosis of bipolar disorders in the elderly is poor due to higher prevalence of recurrences, associated somatic disorders, reduced survival and severe handicap. There is an immediate need for collaboration between patients, families, clinicians, researchers, governmental agencies, and third-party payers to improve the diagnosis, treatment, and delivery of services for elderly subjects with bipolar disorders.