scholarly journals Treatment of bipolar disorders in older adults: a review

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Nemanja Ljubic ◽  
Bianca Ueberberg ◽  
Heinz Grunze ◽  
Hans-Jörg Assion
Keyword(s):  
Older Adults ◽  
Bipolar Disorder ◽  
Old Age ◽  
The Elderly ◽  
Psychiatric Research ◽  
Treatment Modalities ◽  
Treatment Needs ◽  
Course Of Illness ◽  
Mesh Terms

Abstract Background Old age bipolar disorder has been an orphan of psychiatric research for a long time despite the fact that bipolar disorder (BD)-I and II together may affect 0.5–1.0% of the elderly. It is also unclear whether aetiology, course of illness and treatment should differ in patients with a first manifestation in older age and patients suffering from a recurrence of a BD known for decades. This narrative review will summarize the current state of knowledge about the epidemiology, clinical features, and treatment of BD in the elderly. Methods We conducted a Medline literature search from 1970 to 2021 using MeSH terms “Bipolar Disorder” × “Aged” or “Geriatric” or “Elderly”. Search results were complemented by additional literature retrieved from examining cross references and by hand search in text books. Summary of findings Varying cut-off ages have been applied to differentiate old age from adult age BD. Within old age BD, there is a reasonable agreement of distinct entities, early and late-onset BD. They differ to some extent in clinical symptoms, course of illness, and some co-morbidities. Point prevalence of BD in older adults appears slightly lower than in working-age adults, with polarity of episodes shifting towards depression. Psychopharmacological treatment needs to take into account the special aspects of somatic gerontology and the age-related change of pharmacokinetic and pharmacodynamic characteristics. The evidence for commonly used treatments such as lithium, mood-stabilizing antiepileptics, antipsychotics, and antidepressants remains sparse. Preliminary results support a role of ECT as well as psychotherapy and psychosocial interventions in old age BD. Conclusions There is an obvious need of further research for all treatment modalities of BD in old age. The focus should be pharmacological and psychosocial approaches, as well as their combination, and the role of physical treatment modalities such as ECT.

scholarly journals Likelihood of Participation in Home-Based Cognitive Assessment: The Role of Subjective Cognitive Decline and Age

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 293-294
Author(s):  
Moriah Splonskowski ◽  
Holly Cooke ◽  
Claudia Jacova
Keyword(s):  
Older Adults ◽  
Cognitive Decline ◽  
Old Age ◽  
Cognitive Assessment ◽  
Community Dwelling ◽  
Subjective Cognitive Decline ◽  
Cognitive State ◽  
Home Based ◽  
Increased Risk

Abstract Home-based cognitive assessment (HBCA) services are emerging as a convenient alternative to in-clinic cognitive assessment and may aid in mitigating barriers to detecting cognitive impairment (CI). It is unknown which older adults would be likely to participate in HBCA. Here we investigated the role of age and Subjective Cognitive Decline (SCD). SCD has demonstrated an increased risk for progression to CI/dementia. A nation-wide community-dwelling sample of 494 adults age 50+ were recruited via Amazon Mechanical Turk to complete an online survey assessing perceptions around HBCA and SCD. Our sample was 91.9% White and 66.8% female. It consisted of 174 respondents aged 50-60, 265 aged 61- 70, and 55 aged 71-79. Age groups were comparable with respect to their acceptance of cognitive assessment (Range 4-20, higher score=higher acceptance, 7.9±3.3, 8.15±3.2, 8.05±3.43) and SCD-Q total (43.1±5.8, 43.2±5.7, 43.3±5.7). Correlation analysis revealed a relationship between SCD-QSCD total and perceived likelihood of participation in HBCA for those ages 61-70 (r(263) = .222 p = .000), but not for ages 50-60 or 71-79 (r(172) = .102 p = .152; r(53) = -.102 p = .458). Our findings suggest that SCD influences the likelihood of participation in HBCA for older adults’ transitioning to old age (61-70). Findings show that for adults transitioning into old age (61-70), perceived cognitive state influences their likelihood of participation in HBCA. Importantly, concerns about CI/dementia may generate more favorable perceptions of HBCA for this group.

Aspirin Use for Primary Prevention of Cardiovascular Disease in Older Patients: A Review of Clinical Guidelines and Updated Evidence

2019 ◽  
Vol 34 (9) ◽  
pp. 580-594
Author(s):  
Jelena Lewis ◽  
Laressa Bethishou ◽  
Laura V. Tsu
Keyword(s):  
Older Adults ◽  
Primary Prevention ◽  
Older Patients ◽  
Data Extraction ◽  
The Elderly ◽  
Study Selection ◽  
Pubmed Search ◽  
Cv Disease ◽  
Meta Analyses

OBJECTIVE: To provide an up-to-date review of current guidelines, previous trials, and new trials regarding aspirin use in primary prevention of cardiovascular (CV) disease in the elderly population. DATA SOURCES: A PubMed search of articles published through April 2019 was performed using a combination of the following words: aspirin, bleeding, cardiovascular, elderly, hemorrhage, myocardial infarction, primary prevention, stroke. STUDY SELECTION/DATA EXTRACTION: Relevant randomized controlled trials, meta-analyses, and guidelines were assessed for the use of aspirin in primary prevention of CV disease in older patients. References from the above literature were also evaluated. Articles were selected for inclusion based on relevance to the topic, detailed methods, and complete results. DATA SYNTHESIS: The role of aspirin for primary prevention of CV disease in older adults is not well defined. As a result, the guideline recommendations for the use of aspirin in this setting are inconsistent. In 2018, the ARRIVE, ASCEND, and ASPREE studies were published. These studies tried to address some of the inconsistencies regarding the use of aspirin in primary prevention of CV disease. This article reviews the current recommendations along with previous and recent studies for aspirin use for primary prevention in older adults. CONCLUSION: The role of aspirin for primary prevention of CV disease in older adults should be individualized based on patient's risk factors, including risk of CV disease and likelihood of bleeding. Updated evidence provides more guidance regarding which patient populations will benefit from therapy.

EDUCATIONAL ACTIVITY OF OLDER PEOPLE IN POLAND – SELECTED ISSUES

2016 ◽  
Vol 4 ◽  
pp. 122
Author(s):  
Tomasz Różański
Keyword(s):  
Older People ◽  
Old Age ◽  
The Elderly ◽  
Educational Activity ◽  
Human Adaptation

This article is devoted to the issues of educational activity of the elderly in Poland. Defining the term “old age” and drawing attention to the issue of human adaptation to old age were the starting points of the discussion. Next, the most important issues concerning the activity of seniors were raised. Further discussed were the conditions and objectives of the educational activity of older people. An attention was also drawn to the role of institutions, promoting education and culture, in supporting the development of seniors. Moreover, the article refers to the results of selected studies of the issues discussed.  

scholarly journals Status of the Elderly and Emergence of Old Age Homes in India

2018 ◽  
Vol 5 (1) ◽  
pp. 1-4
Author(s):  
Sunita Menezes ◽  
Tissy Mariam Thomas
Keyword(s):  
Older Adults ◽  
Old Age ◽  
Family System ◽  
Elder Abuse ◽  
Nuclear Family ◽  
Care Home ◽  
The Elderly ◽  
Mental Wellbeing ◽  
Meaningful Existence ◽  
Old Age Homes

There has been a rapid ageing of the earth's population and in a few decades, Asia could become the oldest region in the world. In India, due to the reorganization of the family system, the traditional joint family system is on the decline. Due to the emergence of the nuclear family and the high cost of living, family members who previously cared for the elderly need to find employment outside the home. A rapid increase in nuclear families and an exceptional increase in the number of ‘older adults’ in the country have compelled them to live in old age homes. Literature has accentuated the difficulties and apprehensions experienced by older adults during the ageing process and the need for old age homes in order to create an environment that fosters a meaningful existence for them in their twilight years. India's old age homes are trying to uphold the needs, desires and values of older adults. There is a lack of studies that attempt to give older adults a chance to communicate their experiences in a care home. Older adults are an invaluable resource for younger generations and change is needed in society's attitude towards ageing. This review can help psychologists, social workers and caregivers gain insight into the needs of older adults in terms of mental wellbeing, economic and social security and elder abuse and create awareness among the people.   Int. J. Soc. Sc. Manage. Vol. 5, Issue-1: 1-4

scholarly journals Death Anxiety and Loneliness among Older Adults: Role of Parental Self-Efficacy

2021 ◽  
Vol 18 (18) ◽  
pp. 9857
Author(s):  
Lee Greenblatt-Kimron ◽  
Miri Kestler-Peleg ◽  
Ahuva Even-Zohar ◽  
Osnat Lavenda
Keyword(s):  
Older Adults ◽  
Old Age ◽  
Mental Health Professionals ◽  
Self Efficacy ◽  
Death Anxiety ◽  
Intergenerational Relationships ◽  
Background Characteristics ◽  
Convenience Sample ◽  
Daily Lives

Death anxiety and loneliness are major issues for older people. The present study aimed to broaden the understanding of factors that are linked with increased loneliness in old age by examining the association between death anxiety and loneliness, and the role of an unexplored variable among older adults, namely, parental self-efficacy. A convenience sample of 362 Israeli parents over the age of 65 was recruited through means of social media. Participants completed self-reported questionnaires, which included background characteristics, death anxiety, parental self-efficacy, and loneliness measures. The findings showed that death anxiety was positively associated with loneliness among older adults. The findings also confirmed that parental self-efficacy moderated this association in this population. We concluded that the combination of death anxiety and low parental self-efficacy identified a group of older adults that are at higher risk of developing increased loneliness levels. Mental health professionals should consider intergenerational relationships as a fundamental component of older adults’ daily lives, focusing on parental self-efficacy in old age, as this appears to be a resilience resource.

scholarly journals Universal Basic Income as a Way of Redistribution of Experience between Individuals and Groups

2020 ◽  
Vol 63 (3) ◽  
pp. 131-141
Author(s):  
Alexander A. Pisarev
Keyword(s):  
Old Age ◽  
Elderly Care ◽  
The Elderly ◽  
Basic Income ◽  
Gender And Age ◽  
Traditional Societies ◽  
Material Conditions ◽  
Must Experiment ◽  
First Time

This article reviews the possible role of the universal basic income in the transformation of experience in gender and age perspectives. The universal basic income has been particularly hotly debated in recent decades. Regardless of the position, the common tone of the debates is the imperative “we must experiment.” Such a close interest in the universal basic income derives from the fact that it threatens to change the “generic” for humans situation of finiteness of resources and the need to work. Thus, it is able to change the experience of what it means to be human. Since the universal basic income allows to separate labor from income, it is likely that its introduction will return value to the currently stigmatized or devalued types of labor, such as child care, elderly care or domestic work. It creates opportunities for experience redistribution in gender perspective: care and leaving (career break), affective connection, and sensitivity could become the business of both parents, not just mothers. Another experience redistribution is possible in age perspective. Along with automation of labor, population ageing is a universal process that will sooner or later affect all the countries. Alarmist narratives that present this process as a threat and a problem now prevail. They are largely based on outdated ideas about old age and what it means to be old. However, in fact, ageing is the maturation of the population as a whole. With a proper re-evaluation of the meaning and significance of old age, the introduction of the universal basic income could create material conditions for the transfer of experience from the elderly to the younger – for the first time since traditional societies.

scholarly journals Mental Disorders, Cognitive Impairment and the Risk of Suicide in Older Adults

2021 ◽  
Vol 12 ◽  
Author(s):  
Agnieszka Kułak-Bejda ◽  
Grzegorz Bejda ◽  
Napoleon Waszkiewicz
Keyword(s):  
Older Adults ◽  
Bipolar Disorder ◽  
Cognitive Impairment ◽  
Mental Disorders ◽  
Anxiety Disorders ◽  
Older People ◽  
Mood Disorders ◽  
The Elderly ◽  
Increased Risk ◽  
The World

More than 600 million people are aged 60 years and over are living in the world. The World Health Organization estimates that this number will double by 2025 to 2 billion older people. Suicide among people over the age of 60 is one of the most acute problems. The factors strongly associated with suicide are mentioned: physical illnesses, such as cancer, neurologic disorder, pain, liver disease, genital disorders, or rheumatoid disorders. Moreover, neurologic conditions, especially stroke, may affect decision-making processes, cognitive capacity, and language deficit. In addition to dementia, the most common mental disorders are mood and anxiety disorders. A common symptom of these disorders in the elderly is cognitive impairment. This study aimed to present the relationship between cognitive impairment due to dementia, mood disorders and anxiety, and an increased risk of suicide among older people. Dementia is a disease where the risk of suicide is significant. Many studies demonstrated that older adults with dementia had an increased risk of suicide death than those without dementia. Similar conclusions apply to prodromal dementia Depression is also a disease with a high risk of suicide. Many researchers found that a higher level of depression was associated with suicide attempts and suicide ideation. Bipolar disorder is the second entity in mood disorders with an increased risk of suicide among the elderly. Apart from suicidal thoughts, bipolar disorder is characterized by high mortality. In the group of anxiety disorders, the most significant risk of suicide occurs when depression is present. In turn, suicide thoughts are more common in social phobia than in other anxiety disorders. Suicide among the elderly is a serious public health problem. There is a positive correlation between mental disorders such as dementia, depression, bipolar disorder, or anxiety and the prevalence of suicide in the elderly. Therefore, the elderly should be comprehensively provided with psychiatric and psychological support.

Role of positive pressure therapy on sleep disordered breathing and cognition in the elderly

2017 ◽  
Author(s):  
Molly E. Zimmerman ◽  
Mark S. Aloia
Keyword(s):  
Older Adults ◽  
Sleep Disordered Breathing ◽  
Randomized Clinical Trials ◽  
The Elderly ◽  
Positive Pressure ◽  
Cognitive Changes ◽  
Pressure Therapy ◽  
Age Related ◽  
Disordered Breathing

Efforts aimed toward alleviating senescence have intensified as older adults occupy an increasing proportion of the population. Cognitive abilities become compromised with advancing age, with a vast heterogeneity of presentations, ranging from occasional word-finding difficulties to dementia. The role of sleep disordered breathing (SDB) in moderating or mediating age-related cognitive decline is particularly relevant given its potential reversibility in response to positive airway pressure (PAP) therapies. Establishment of SDB as a significant contributor to the development of dementia and cognitive dysfunction among the elderly has immense public health relevance, underscoring the importance of its early identification and treatment. Although several studies have examined the effect of PAP on cognitive function in older adults with SDB, additional prospective randomized clinical trials are needed. This chapter reviews the literature on SDB and cognition among the elderly as well as cognitive changes in response to PAP. Considerations for future research are also discussed.

scholarly journals The breadth of attention in old age

2012 ◽  
Vol 3 (1) ◽  
pp. 10 ◽  
Author(s):  
Stefanie Hüttermann ◽  
Otmar Bock ◽  
Daniel Memmert
Keyword(s):  
Older Adults ◽  
Visual Field ◽  
Old Age ◽  
Attention Deficits ◽  
Eye Position ◽  
Visual Periphery ◽  
Age Related ◽  
Breadth Of Attention

Older adults typically have more difficulties than younger ones in situations that require attention in the visual periphery, such as driving a car or riding a bicycle. Previous studies accordingly found that the breadth of attention decreases in old age when one attention-demanding task is presented at fixation and simultaneously another one in the visual periphery. The present work evaluates the role of eye position for the observed deficit by presenting both tasks in the visual periphery (condition peripheral-peripheral) or by leaving it up to the subjects where in the visual field the tasks appear (condition free-gaze). Our data indicate that attention breadth decreases by 27% from the age of early 20 to the age of late 60 in both conditions. This outcome generalizes previous findings about age-related attention deficits to scenarios that were not explored in previous studies, yet are relevant for everyday behavior.

Immunology of Bipolar Disorder

2018 ◽  
pp. 211-226
Author(s):  
Izabela G. Barbosa ◽  
Moises E. Bauer ◽  
Jair C. Soares ◽  
Antônio L. Teixeira
Keyword(s):  
Bipolar Disorder ◽  
Mononuclear Cells ◽  
Immune Cell ◽  
Course Of Illness ◽  
Wide Range ◽  
High Prevalence ◽  
The Central Nervous System ◽  
Immune Changes ◽  
Inflammatory Changes

Bipolar disorder (BD) is a severe, chronic, and recurrent psychiatric illness. It has been associated with a high prevalence of medical and psychiatric comorbidities, cognitive impairment, and a progressive course of illness. Its neurobiology is not completely understood, but recent evidence has shown a wide range of immune changes. Here we review several data supporting the presence of immunological dysfunction in BD: (1) increased frequency of autoimmune diseases; (2) distinct immune cell profile; (3) altered release of cytokines by stimulated mononuclear cells; (4) elevated levels of circulating immune markers; (5) inflammatory changes in the central nervous system; (6) relationship with clinical comorbidities; and (7) the effect of current treatments on the immune system and the role of immunomodulatory agents.

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