ÁREA, Assistance and Research in Affective Disorders, Buenos Aires, Argentina.
Bipolar Disorder Program, Neurosciences Institute, Favaloro University, Buenos Aires, Argentina.
Int J Geriatr Psychiatry. 2019 Jul;34(7):950-956. doi: 10.1002/gps.5094. Epub 2019 Apr 17.
Characterization of clinical course in old age bipolar disorder (OABD) is scarce and based solely on episode density (ED). The aim of this study was to explore mood instability (MI) and subsyndromal symptomatology (SS) in a prospective cohort of OABD. Further, we contrasted these measures with a cohort of young age bipolar disorder (YABD).
Life charts from weekly mood ratings were used to compute the number of weeks spent with subsyndromal symptoms (SD), the ED, and the MI during follow-up for a cohort of OABD (N = 38) that excluded late onset BD. Linear and logistic regression models were fitted to compare the clinical course of OABD with a cohort of YABD (N = 52) and to explore the relationship between these measures and functional outcomes.
Median follow-up was 5 years (IQR: 3.6-7.9). OABD (61.6 years, SD: 8.3) spent 15%, 6%, and 3% of their follow-up with depressive, manic, and mixed symptoms, respectively, and suffered 4.2 mood changes per year (SD: 2.6). No significant differences between OABD and YABD regarding ED or MI emerged in multivariate analysis, while a higher subsyndromal manic symptom burden was observed in OABD (β coefficient: 3.79, 95%CI: 0.4-7.2). Both SS and MI were associated with functional outcomes in OABD.
The course of illness throughout OABD was similar to the one observed in YABD except for a higher subsyndromal manic burden. This study extended the association of MI and SD with global functioning to the late-life BD.
老年双相情感障碍（OABD）的临床病程特征稀缺，仅基于发作密度（ED）。本研究旨在探讨前瞻性 OABD 队列中的情绪不稳定（MI）和亚综合征症状（SS）。此外，我们将这些措施与年轻年龄双相情感障碍（YABD）队列进行了对比。
使用每周情绪评分的生命图表来计算亚综合征症状（SD）、ED 和 MI 在排除晚发性 BD 后的 OABD 队列（N=38）随访期间所花费的周数。线性和逻辑回归模型用于比较 OABD 的临床病程与 YABD 队列，并探讨这些措施与功能结果之间的关系。
中位随访时间为 5 年（IQR：3.6-7.9）。OABD（61.6 岁，SD：8.3）分别有 15%、6%和 3%的时间处于抑郁、躁狂和混合症状状态，每年发生 4.2 次情绪变化（SD：2.6）。在多变量分析中，OABD 和 YABD 之间在 ED 或 MI 方面没有显著差异，而 OABD 中观察到更高的亚综合征躁狂症状负担（β系数：3.79，95%CI：0.4-7.2）。SS 和 MI 均与 OABD 的功能结果相关。
除了亚综合征躁狂负担较高外，OABD 的整个病程与 YABD 相似。本研究将 MI 和 SD 与总体功能的关联扩展到老年 BD。
