Department of Old Age Psychiatry.
Bipolar Disord. 2014 Mar;16(2):113-8. doi: 10.1111/bdi.12104. Epub 2013 Aug 6.
Since there is a worldwide steady increase in the number of individuals living longer and an expected increase in the number of older adults who will be diagnosed with bipolar disorder, there is a growing need to better understand late-life mania. We provide in this review a report of published studies focusing on the prevalence of late-life mania in the community and in senior psychiatric care facilities.
We conducted a search of PubMed and Psychinfo databases using combinations of the keywords bipolar, manic/a, manic depression, elderly, and older including English-language reports presenting quantitative data on the prevalence of mania in adults over the age of 50 years.
Eighteen out of 188 potentially eligible studies met our inclusion criteria, with most studies focusing on psychiatric inpatient samples. The overall prevalence of late-life mania was estimated to be 6.0% in the reported 1,519 older psychiatric inpatients. In elderly inpatients with bipolar disorder, the mean prevalence of late-onset mania was 44.2%. For other relevant care facilities, no firm conclusions could be drawn.
Late-life mania is not rare in older psychiatric inpatients and late-onset mania is associated with increased somatic comorbidity in patients aged 50 years and older. Several hypotheses regarding the relationship between somatic illness and late-life mania in the elderly have been proposed and studies on this relationship and the prevalence of late-life mania in different senior psychiatric care facilities deserve specific attention in future research projects.
随着全球范围内长寿人口数量的稳步增长，以及被诊断为双相情感障碍的老年患者数量预计将会增加，因此，我们越来越需要更好地了解老年期躁狂症。本综述报告了针对社区和老年精神科医疗机构中老年期躁狂症患病率的已发表研究。
我们使用了“bipolar”“manic/a”“manic depression”“elderly”和“older”等关键词，在 PubMed 和 Psychinfo 数据库中进行了检索，结合了这些关键词的英文文献，包括提供了 50 岁以上成年人躁狂症患病率的定量数据的报告。
在 188 篇潜在符合条件的研究中，有 18 篇符合我们的纳入标准，其中大多数研究都集中在精神科住院患者样本上。在报告的 1519 名老年精神科住院患者中，老年期躁狂症的总体患病率估计为 6.0%。在患有双相情感障碍的老年住院患者中，晚发性躁狂症的平均患病率为 44.2%。对于其他相关的护理机构，无法得出明确的结论。
老年期躁狂症在老年精神科住院患者中并不罕见，晚发性躁狂症与 50 岁及以上患者的躯体共病增加有关。已经提出了几个关于躯体疾病与老年期躁狂症之间关系的假说，关于这种关系以及不同老年精神科护理机构中老年期躁狂症的患病率的研究，值得在未来的研究项目中给予特别关注。
