Lisa T Eyler1, Michelle E Aebi2, Rebecca E Daly3, Kristen Hansen4, Curtis Tatsuoka5, Robert C Young6, Martha Sajatovic7. 1. Department of Psychiatry (LTE, RED), University of California San Diego, San Diego; Desert-Pacific Mental Illness Research Education and Clinical Center (LTE), VA San Diego Healthcare System, San Diego. 2. Department of Psychiatry (MEA, MS), Case Western Reserve University School of Medicine, Cleveland. 3. Department of Psychiatry (LTE, RED), University of California San Diego, San Diego. 4. Division of Biostatistics (KH), University of California San Diego, San Diego. 5. Department of Neurology (CT, MS), Case Western Reserve University School of Medicine, Cleveland; Neurological and Behavioral Outcomes Center (CT, MS), Case Western Reserve University School of Medicine, Cleveland. 6. Weill Cornell Medicine and New York Presbyterian Hospital (RCY), New York. 7. Department of Psychiatry (MEA, MS), Case Western Reserve University School of Medicine, Cleveland; Department of Neurology (CT, MS), Case Western Reserve University School of Medicine, Cleveland; Neurological and Behavioral Outcomes Center (CT, MS), Case Western Reserve University School of Medicine, Cleveland. Electronic address: Martha.sajatovic@uhhospitals.org.
Abstract
OBJECTIVE: Although 25% of people with bipolar disorder (BD) are over age 60, there is a dearth of research on older age bipolar disorder (OABD). This report describes an initial effort to create an integrated OABD database using the U.S. National Institute of Mental Health Data Archive (NDA). Goals were to: 1) combine data from three BD studies in the United States that included overlapping data elements; 2) investigate research questions related to aims of the original studies; and 3) take an important first step toward combining existing datasets relevant to aging and BD. METHODS: Data were prepared and uploaded to the NDA, with a focus on data elements common to all studies. As appropriate, data were harmonized to select or collapse categories suitable for cross-walk analysis. Associations between age, BD symptoms, functioning, medication load, medication adherence, and medical comorbidities were assessed. The total sample comprised 451 individuals, mean age 57.7 (standard deviation: 13.1) years. RESULTS: Medical comorbidity was not significantly associated with either age or functioning and there did not appear to be an association between medication load, comorbidity, age, and adherence. Men and African-Americans were significantly more likely to have poor adherence. Both BD mania and depression symptoms were associated with functioning, but this differed across studies. CONCLUSION: Despite limitations including heterogeneity in study design and samples and cross-sectional methodology, integrated datasets represent an opportunity to better understand how aging may impact the presentation and evolution of chronic mental health disorders across the lifespan.
OBJECTIVE: Although 25% of people with bipolar disorder (BD) are over age 60, there is a dearth of research on older agebipolar disorder (OABD). This report describes an initial effort to create an integrated OABD database using the U.S. National Institute of Mental Health Data Archive (NDA). Goals were to: 1) combine data from three BD studies in the United States that included overlapping data elements; 2) investigate research questions related to aims of the original studies; and 3) take an important first step toward combining existing datasets relevant to aging and BD. METHODS: Data were prepared and uploaded to the NDA, with a focus on data elements common to all studies. As appropriate, data were harmonized to select or collapse categories suitable for cross-walk analysis. Associations between age, BD symptoms, functioning, medication load, medication adherence, and medical comorbidities were assessed. The total sample comprised 451 individuals, mean age 57.7 (standard deviation: 13.1) years. RESULTS: Medical comorbidity was not significantly associated with either age or functioning and there did not appear to be an association between medication load, comorbidity, age, and adherence. Men and African-Americans were significantly more likely to have poor adherence. Both BD mania and depression symptoms were associated with functioning, but this differed across studies. CONCLUSION: Despite limitations including heterogeneity in study design and samples and cross-sectional methodology, integrated datasets represent an opportunity to better understand how aging may impact the presentation and evolution of chronic mental health disorders across the lifespan.
Authors: M D Miller; C F Paradis; P R Houck; S Mazumdar; J A Stack; A H Rifai; B Mulsant; C F Reynolds Journal: Psychiatry Res Date: 1992-03 Impact factor: 3.222