Comorbidities common and varied among geriatric bipolar disorder patients

A study of comorbidity patterns among geriatric patients with bipolar disorder has revealed substance abuse, anxiety disorders and dementia to be represented in 29% of patients, with each comorbidity having its own clinical characteristics and unique healthcare requirements.Comorbidity patterns among the elderly with bipolar disorder are not well understood, and there is little published literature in the area of mood disorders in the elderly. The aim of the study by Sajatovic et al. was to examine the prevalence of anxiety disorders, substance abuse and dementia in geriatric patients with bipolar disorder and compare data on healthcare service use and cost of these disorders by psychiatric comorbidity.A total of 4,668 geriatric patients (mean age 70 years) with bipolar disorder and comorbid post-traumatic stress disorder (PTSD), substance abuse, other anxiety disorders, or dementia (28.6% of all patients identified in a Veterans Health Administration database as having bipolar disorder and being aged 60 years or older).Of the geriatric veterans with bipolar disorder, comorbid substance abuse was seen in 8.9% of patients, PTSD in 5.4%, other anxiety disorders in 9.7%, and dementia in 4.5% of patients.The analysis revealed that approximately one-third of veterans with comorbid substance abuse were married, compared with a marriage rate of 55-65% in the other comorbidities. Homelessness was also found to be much more common among individuals with comorbid substance abuse occurring at a rate of 13.2% compared with 2% or less for other comorbidities.Compared to the bipolar patients with comorbid PTSD, substance abuse, anxiety or dementia, patients with bipolar disorder who did not have these comorbidities had fewer hospitalisations (pppThe authors noted that "combat-related PTSD would be expected to be uncommon in general bipolar populations, and combat-related versus non-combat-related PTSD are know to have potentially different courses and outcomes."The results of the analysis demonstrated that 29% of geriatric patients with bipolar disorder have a comorbidity of PTSD, substance abuse, other anxiety disorders or dementia. Clinical characteristics, health resource use and healthcare costs are dependent on the type of comorbidity.The authors concluded: "Additional research is needed to better understand presentation of illness and modifiable factors that may influence outcomes."Reference...