An epidemiological profile of bipolar disorder among older adults with complex needs: a national cross-sectional study

Schluter, Philip J., Lacey, Cameron, Porter, Richard J. and Jamieson, Hamish A. (2017) An epidemiological profile of bipolar disorder among older adults with complex needs: a national cross-sectional study. Bipolar Disorders, 19 5: 375-385. doi:10.1111/bdi.12511


Author Schluter, Philip J.
Lacey, Cameron
Porter, Richard J.
Jamieson, Hamish A.
Title An epidemiological profile of bipolar disorder among older adults with complex needs: a national cross-sectional study
Journal name Bipolar Disorders   Check publisher's open access policy
ISSN 1399-5618
1398-5647
Publication date 2017-08-01
Sub-type Article (original research)
DOI 10.1111/bdi.12511
Open Access Status Not yet assessed
Volume 19
Issue 5
Start page 375
End page 385
Total pages 11
Place of publication Hoboken, NJ, United States
Publisher Wiley-Blackwell Publishing
Language eng
Subject 2738 Psychiatry and Mental health
2803 Biological Psychiatry
Abstract Objectives: Research on bipolar disorder (BD) among community-living older adults is scant and often suffers from important methodological limitations. Using a national database, this study presents an epidemiological profile of BD in older community residents within New Zealand. Methods: Since 2012, all New Zealand community care recipients have undergone a standardized needs assessment using the Home Care International Residential Assessment Instrument (interRAI-HC). The interRAI-HC elicits information using 236 questions over 20 domains, including BD diagnosis. Those who were assessed between 1 September 2012 and 31 January 2016, who were aged ≥65 years, and who provided consent were included. Statistical investigations employed bivariable and multivariable logistic regression models. Results: Overall, 71 859 people were eligible; their average age was 82.7 years (range 65-105 years), with 43 802 (61.0%) being female and 798 (1.1%) having a BD diagnosis. Participants' sex, age and ethnic identification were significantly related to BD (all P<.001). Participants with a higher number of comorbidities had greater odds of BD; for those with at least six comorbidities, the adjusted odds ratio (AOR) was 2.32 (95% confidence interval [CI] 1.37-3.92). Almost all considered social and environmental variables were significantly and detrimentally associated with BD, such as living in squalid conditions (2.7% for those with DB vs 1.1% for those without DB; AOR=1.60 [95% CI 1.06-2.42]). Conclusions: BD among older adults is not uncommon, and numbers will increase as populations age. Increasingly, health services are moving to home-based integrated models of care. Clinicians and decision-makers need to be aware in their planning and service delivery that significant deficits in environment quality and exposure to stressful living circumstances remain for older adults with BD.
Keyword Bipolar disorder
Community care assessment
Epidemiology
National study
Older adults
Population health
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
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