Demographic and clinical characteristics of lithium-treated older adults with bipolar disorder

GAGE-BD initiative

doi:10.1111/acps.13474

Demographic and clinical characteristics of lithium-treated older adults with bipolar disorder

GAGE-BD initiative

Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK; Bipolar and Depressive Disorders Unit, Department of Psychiatry and Psychology, Institute of Neurosciences, Hospital Clínic de Barcelona, IDIBAPS, CIBERSAM, Spain.
Dalhousie University
School of Women's and Infants' Health, The University of Western Australia, Perth, Western Australia, 6009, Australia.
Howard Hughes Medical Institute, Yale University, New Haven, CT 06519, USA; Department of Medicine, Yale University School of Medicine, New Haven, CT 06520, USA; Department of Cellular and Molecular Physiology, Yale University School of Medicine, New Haven, CT 06520, USA.
Case Western Reserve University School of Medicine, University Hospitals Case Medical Center, Cleveland, OH, USA.
Max Planck Institute of Psychiatry, Department of Translational Research in Psychiatry, Munich, Germany.
University of California San Diego School of Medicine , San Diego, California , USA.
McLean Hospital, Belmont, United States
7 Center for Pulmonary Vascular Biology and Medicine, Pittsburgh Heart, Lung, Blood, and Vascular Medicine Institute, Division of Cardiology, Department of Medicine, University of Pittsburgh School of Medicine and University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania.
Institute of Neuropathology; IDIBELL-University Hospital Bellvitge, University of Barcelona; Hospitalet de Llobregat, Barcelona, 08908, Spain.
University of Toronto and Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada.
Montreal Neurological Institute and McGill University Health Centre, McGill University, Montreal, QC, Canada.
Department of Psychiatry, Taipei Medical University Hospital, Taipei, Taiwan.

Research output: Contribution to journal › Article › Academic › peer-review

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Abstract

OBJECTIVES: There is limited information on the characteristics of older adults with bipolar disorder (OABD) treated with lithium, along with safety concerns about its use by older adults. The aim of the present study is to describe the demographic and clinical characteristics of OABD receiving lithium therapy, using data from the Global Ageing & Geriatric Experiments in Bipolar Disorder (GAGE-BD).

EXPERIMENTAL PROCEDURES: Cross-sectional analysis of the GAGE-BD dataset to determine differences and similarities between lithium users and non-users. We analysed data from 986 participants aged 50 years or older (mean age 63.5 years; 57.5% females) from 12 study sites. Two subgroups ('Lithium'; 'Non-lithium') were defined according to the current prescription of lithium. We compared several outcomes between these groups, controlling for age, gender, and study site.

RESULTS: OABD treated with lithium had lower scores on depression rating scales and were less likely to be categorised as with moderate or severe depression. There was a lower proportion of lithium users than non-users among those with evidence of rapid cycling and non-bipolar psychiatric diagnoses. Assessment of global cognitive state and functionality indicated better performance among lithium users. The current use of antipsychotics was less frequent among lithium users, who also reported fewer cardiovascular comorbidities than non-users.

CONCLUSION: We found several potentially relevant differences in the clinical profile of OABD treated with lithium compared with those treated with other mood stabilisers. However, the interpretation of the present results must take into account the methodological limitations inherent to the cross-sectional approach and data harmonisation.

Original language	English
Pages (from-to)	442-455
Number of pages	14
Journal	Acta psychiatrica Scandinavica
Volume	146
Issue number	5
Early online date	15 Jul 2022
DOIs	https://doi.org/10.1111/acps.13474
Publication status	Published - Nov 2022

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 3 Good Health and Well-being

Keywords

bipolar disorder
lithium
older adults
pharmacology

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Demographic-and-clinical-characteristics-of-lithium-treated-older-adults-with-bipolar-disorder.pdfFinal published version, 1.36 MB

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@article{6828caee98b14963b650c08a5b79e8d4,

title = "Demographic and clinical characteristics of lithium-treated older adults with bipolar disorder",

abstract = "OBJECTIVES: There is limited information on the characteristics of older adults with bipolar disorder (OABD) treated with lithium, along with safety concerns about its use by older adults. The aim of the present study is to describe the demographic and clinical characteristics of OABD receiving lithium therapy, using data from the Global Ageing \& Geriatric Experiments in Bipolar Disorder (GAGE-BD).EXPERIMENTAL PROCEDURES: Cross-sectional analysis of the GAGE-BD dataset to determine differences and similarities between lithium users and non-users. We analysed data from 986 participants aged 50 years or older (mean age 63.5 years; 57.5\% females) from 12 study sites. Two subgroups ('Lithium'; 'Non-lithium') were defined according to the current prescription of lithium. We compared several outcomes between these groups, controlling for age, gender, and study site.RESULTS: OABD treated with lithium had lower scores on depression rating scales and were less likely to be categorised as with moderate or severe depression. There was a lower proportion of lithium users than non-users among those with evidence of rapid cycling and non-bipolar psychiatric diagnoses. Assessment of global cognitive state and functionality indicated better performance among lithium users. The current use of antipsychotics was less frequent among lithium users, who also reported fewer cardiovascular comorbidities than non-users.CONCLUSION: We found several potentially relevant differences in the clinical profile of OABD treated with lithium compared with those treated with other mood stabilisers. However, the interpretation of the present results must take into account the methodological limitations inherent to the cross-sectional approach and data harmonisation.",

keywords = "bipolar disorder, lithium, older adults, pharmacology",

author = "\{GAGE-BD initiative\} and Forlenza, \{Orestes V\} and Tomas Hajek and Almeida, \{Osvaldo P\} and Beunders, \{Alexandra J M\} and Blumberg, \{Hilary P\} and Briggs, \{Farren B S\} and De-Paula, \{Vanessa J R\} and Annemiek Dols and Eyler, \{Lisa T\} and Forester, \{Brent P\} and Ariel Gildengers and Esther Jimenez and Korten, \{Nicole C M\} and Beny Lafer and McWhinney, \{Sean R\} and Benoit Mulsant and Soham Rej and Kaylee Sarna and Sigfried Schouws and Ashley Sutherland and Shangying Tsai and Eduard Vieta and Joy Yala and Martha Sajatovic",

note = "Funding Information: Research reported in this publication was supported by the ISBD Bowden Massey Strategic Research Initiative in Bipolar Disorder Award and made possible by logistical support from the ISBD. Support was also received from the Clinical and Translational Science Collaborative (CTSC) of Cleveland which is funded by the National Institutes of Health (NIH), National Center for Advancing Translational Science (NCATS), Clinical and Translational Science Award (CTSA) grant (UL1TR002548). Hilary Blumberg is supported by (NIH grant R01 MH113230). The corresponding author's work is supported by research grants from FAPESP (2019/08507‐3, 2014/50873‐3), CNPq (465,412/2014‐9) and Associa{\c c}{\~a}o Beneficente Alzira Denise Hertzog da Silva (ABADHS). Funding Information: Bowden Massey Strategic Research Initiative in Bipolar Disorder Award; Clinical and Translational Science Collaborative of Cleveland, School of Medicine, Case Western Reserve University; FAPESP (2019/08507‐3, 2014/50873‐3), CNPq (465412/2014‐9); National Institutes of Health (NIH), National Center for Advancing Translational Science (NCATS), Clinical and Translational Science Award (CTSA) grant (UL1TR002548); NIH grant R01 MH113230 Funding information Publisher Copyright: {\textcopyright} 2022 John Wiley \& Sons A/S. Published by John Wiley \& Sons Ltd.",

year = "2022",

month = nov,

doi = "10.1111/acps.13474",

language = "English",

volume = "146",

pages = "442--455",

journal = "Acta psychiatrica Scandinavica",

issn = "0001-690X",

publisher = "Wiley Blackwell",

number = "5",

}

TY - JOUR

T1 - Demographic and clinical characteristics of lithium-treated older adults with bipolar disorder

AU - GAGE-BD initiative

AU - Forlenza, Orestes V

AU - Hajek, Tomas

AU - Almeida, Osvaldo P

AU - Beunders, Alexandra J M

AU - Blumberg, Hilary P

AU - Briggs, Farren B S

AU - De-Paula, Vanessa J R

AU - Dols, Annemiek

AU - Eyler, Lisa T

AU - Forester, Brent P

AU - Gildengers, Ariel

AU - Jimenez, Esther

AU - Korten, Nicole C M

AU - Lafer, Beny

AU - McWhinney, Sean R

AU - Mulsant, Benoit

AU - Rej, Soham

AU - Sarna, Kaylee

AU - Schouws, Sigfried

AU - Sutherland, Ashley

AU - Tsai, Shangying

AU - Vieta, Eduard

AU - Yala, Joy

AU - Sajatovic, Martha

N1 - Funding Information: Research reported in this publication was supported by the ISBD Bowden Massey Strategic Research Initiative in Bipolar Disorder Award and made possible by logistical support from the ISBD. Support was also received from the Clinical and Translational Science Collaborative (CTSC) of Cleveland which is funded by the National Institutes of Health (NIH), National Center for Advancing Translational Science (NCATS), Clinical and Translational Science Award (CTSA) grant (UL1TR002548). Hilary Blumberg is supported by (NIH grant R01 MH113230). The corresponding author's work is supported by research grants from FAPESP (2019/08507‐3, 2014/50873‐3), CNPq (465,412/2014‐9) and Associação Beneficente Alzira Denise Hertzog da Silva (ABADHS). Funding Information: Bowden Massey Strategic Research Initiative in Bipolar Disorder Award; Clinical and Translational Science Collaborative of Cleveland, School of Medicine, Case Western Reserve University; FAPESP (2019/08507‐3, 2014/50873‐3), CNPq (465412/2014‐9); National Institutes of Health (NIH), National Center for Advancing Translational Science (NCATS), Clinical and Translational Science Award (CTSA) grant (UL1TR002548); NIH grant R01 MH113230 Funding information Publisher Copyright: © 2022 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

PY - 2022/11

Y1 - 2022/11

N2 - OBJECTIVES: There is limited information on the characteristics of older adults with bipolar disorder (OABD) treated with lithium, along with safety concerns about its use by older adults. The aim of the present study is to describe the demographic and clinical characteristics of OABD receiving lithium therapy, using data from the Global Ageing & Geriatric Experiments in Bipolar Disorder (GAGE-BD).EXPERIMENTAL PROCEDURES: Cross-sectional analysis of the GAGE-BD dataset to determine differences and similarities between lithium users and non-users. We analysed data from 986 participants aged 50 years or older (mean age 63.5 years; 57.5% females) from 12 study sites. Two subgroups ('Lithium'; 'Non-lithium') were defined according to the current prescription of lithium. We compared several outcomes between these groups, controlling for age, gender, and study site.RESULTS: OABD treated with lithium had lower scores on depression rating scales and were less likely to be categorised as with moderate or severe depression. There was a lower proportion of lithium users than non-users among those with evidence of rapid cycling and non-bipolar psychiatric diagnoses. Assessment of global cognitive state and functionality indicated better performance among lithium users. The current use of antipsychotics was less frequent among lithium users, who also reported fewer cardiovascular comorbidities than non-users.CONCLUSION: We found several potentially relevant differences in the clinical profile of OABD treated with lithium compared with those treated with other mood stabilisers. However, the interpretation of the present results must take into account the methodological limitations inherent to the cross-sectional approach and data harmonisation.

AB - OBJECTIVES: There is limited information on the characteristics of older adults with bipolar disorder (OABD) treated with lithium, along with safety concerns about its use by older adults. The aim of the present study is to describe the demographic and clinical characteristics of OABD receiving lithium therapy, using data from the Global Ageing & Geriatric Experiments in Bipolar Disorder (GAGE-BD).EXPERIMENTAL PROCEDURES: Cross-sectional analysis of the GAGE-BD dataset to determine differences and similarities between lithium users and non-users. We analysed data from 986 participants aged 50 years or older (mean age 63.5 years; 57.5% females) from 12 study sites. Two subgroups ('Lithium'; 'Non-lithium') were defined according to the current prescription of lithium. We compared several outcomes between these groups, controlling for age, gender, and study site.RESULTS: OABD treated with lithium had lower scores on depression rating scales and were less likely to be categorised as with moderate or severe depression. There was a lower proportion of lithium users than non-users among those with evidence of rapid cycling and non-bipolar psychiatric diagnoses. Assessment of global cognitive state and functionality indicated better performance among lithium users. The current use of antipsychotics was less frequent among lithium users, who also reported fewer cardiovascular comorbidities than non-users.CONCLUSION: We found several potentially relevant differences in the clinical profile of OABD treated with lithium compared with those treated with other mood stabilisers. However, the interpretation of the present results must take into account the methodological limitations inherent to the cross-sectional approach and data harmonisation.

KW - bipolar disorder

KW - lithium

KW - older adults

KW - pharmacology

UR - https://www.scopus.com/pages/publications/85135013778

U2 - 10.1111/acps.13474

DO - 10.1111/acps.13474

M3 - Article

SN - 0001-690X

VL - 146

SP - 442

EP - 455

JO - Acta psychiatrica Scandinavica

JF - Acta psychiatrica Scandinavica

IS - 5

ER -

Demographic and clinical characteristics of lithium-treated older adults with bipolar disorder

Abstract

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Keywords

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