Risk of dementia and death in community-dwelling older men with bipolar disorder

BackgroundBipolar disorder has been associated with cognitive decline, but confirmatory evidence from a community-derived sample of older people is lacking.AimsTo investigate the 13-year risk of dementia and death in older adults with bipolar disorder.MethodCohort study of 37 768 men aged 65–85 years. Dementia (primary) and death (secondary), as recorded by electronic record linkage, were the outcomes of interest.ResultsBipolar disorder was associated with increased adjusted hazard ratio (HR) of dementia (HR = 2.30, 95% CI 1.80–2.94). The risk of dementia was greatest among those with <5 years of history of bipolar disorder or who had had illness onset after 70 years of age. Bipolar disorder was also associated with increased mortality (HR = 1.51, 95% CI 1.28–1.77). Competing risk regression showed that bipolar disorder was associated with increased hazard of death by suicide, accidents, pneumonia or influenza, and diseases of the liver and digestive system.ConclusionsBipolar disorder in later life is associated with increased risk of dementia and premature death.

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Pregnancy, pregnancy loss and the risk of diabetes in Chinese women: findings from the China Kadoorie Biobank

European Journal of Epidemiology ◽

10.1007/s10654-019-00582-7 ◽

2019 ◽

Vol 35 (3) ◽

pp. 295-303

Author(s):

Sanne A. E. Peters ◽

◽

Ling Yang ◽

Yu Guo ◽

Yiping Chen ◽

...

Keyword(s):

Pregnancy Loss ◽

Cox Regression ◽

Chinese Women ◽

Later Life ◽

Induced Abortion ◽

Hazard Ratios ◽

Increased Risk ◽

History Of ◽

Incident Cases

AbstractPregnancy and pregnancy loss may be associated with increased risk of diabetes in later life. However, the evidence is inconsistent and sparse, especially among East Asians where reproductive patterns differ importantly from those in the West. We examined the associations of pregnancy and pregnancy loss (miscarriage, induced abortion, and still birth) with the risk of incident diabetes in later life among Chinese women. In 2004–2008, the nationwide China Kadoorie Biobank recruited 302 669 women aged 30–79 years from 10 (5 urban, 5 rural) diverse localities. During 9.2 years of follow-up, 7780 incident cases of diabetes were recorded among 273,383 women without prior diabetes and cardiovascular disease at baseline. Cox regression yielded multiple-adjusted hazard ratios (HRs) for the risk of diabetes associated with pregnancy and pregnancy loss. Overall, 99% of women had been pregnant, of whom 10%, 53%, and 6% reported having a history of miscarriage, induced abortion, and stillbirth, respectively. Among ever pregnant women, each additional pregnancy was associated with an adjusted HR of 1.04 (95% CI 1.03; 1.06) for diabetes. Compared with those without pregnancy loss, women with a history of pregnancy loss had an adjusted HR of 1.07 (1.02; 1.13) and the HRs increased with increasing number of pregnancy losses, irrespective of the number of livebirths; the adjusted HR was 1.03 (1.00; 1.05) for each additional pregnancy loss. The strength of the relationships differed marginally by type of pregnancy loss. Among Chinese women, a higher number of pregnancies and pregnancy losses were associated with a greater risk of diabetes.

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Differences in outcomes between older community‐dwelling patients with bipolar disorder and schizophrenia with illness onset at young age

Psychogeriatrics ◽

10.1111/psyg.12514 ◽

2020 ◽

Vol 20 (4) ◽

pp. 363-369 ◽

Cited By ~ 2

Author(s):

Po‐Chiao Liao ◽

Kuo‐Hsuan Chung ◽

Pao‐Huan Chen ◽

Chian‐Jue Kuo ◽

Yu‐Jui Huang ◽

...

Keyword(s):

Bipolar Disorder ◽

Community Dwelling ◽

Young Age ◽

Illness Onset

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Disruptive mood dysregulation disorder in offspring of parents with depression and bipolar disorder

The British Journal of Psychiatry ◽

10.1192/bjp.bp.117.198754 ◽

2017 ◽

Vol 210 (6) ◽

pp. 408-412 ◽

Cited By ~ 7

Author(s):

Lukas Propper ◽

Jill Cumby ◽

Victoria C. Patterson ◽

Vladislav Drobinin ◽

Jacqueline M. Glover ◽

...

Keyword(s):

Bipolar Disorder ◽

Major Depressive Disorder ◽

Family History ◽

Depressive Disorder ◽

Control Group ◽

Major Depressive ◽

Disruptive Mood Dysregulation Disorder ◽

Increased Risk ◽

History Of ◽

Mood Dysregulation

BackgroundIt has been suggested that offspring of parents with bipolar disorder are at increased risk for disruptive mood dysregulation disorder (DMDD), but the specificity of this association has not been established.AimsWe examined the specificity of DMDD to family history by comparing offspring of parents with (a) bipolar disorder, (b) major depressive disorder and (c) a control group with no mood disorders.MethodWe established lifetime diagnosis of DMDD using the Schedule for Affective Disorders and Schizophrenia for School Aged Children for DSM-5 in 180 youth aged 6–18 years, including 58 offspring of parents with bipolar disorder, 82 offspring of parents with major depressive disorder and 40 control offspring.ResultsDiagnostic criteria for DMDD were met in none of the offspring of parents with bipolar disorder, 6 of the offspring of parents with major depressive disorder and none of the control offspring. DMDD diagnosis was significantly associated with family history of major depressive disorder.ConclusionsOur results suggest that DMDD is not specifically associated with a family history of bipolar disorder and may be associated with parental depression.

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Course of Bipolar Disorders

Bipolar Disorder ◽

10.1093/med/9780190908096.003.0003 ◽

2020 ◽

pp. 29-42

Author(s):

Luis R. Patino Duran ◽

Melissa P. DelBello

Keyword(s):

Bipolar Disorder ◽

Psychiatric Symptoms ◽

Bipolar Disorders ◽

Manic Episode ◽

Premature Death ◽

Medical Problems ◽

Course Of Illness ◽

Factors Affecting ◽

Illness Onset ◽

Disease Rates

Bipolar disorder is a lifelong condition in most individuals, with a complex and dynamic course of illness that consists of recurrent affective episodes complicated by other psychiatric and behavioral symptoms. Before illness onset, at-risk individuals demonstrate nonspecific psychiatric symptoms that evolve into, usually, depressive episodes and ultimately mania or hypomania during adolescence. Recovery after a first manic episode is typical, but recurrences are common, and with more episodes, the risk for recurrences increases. A number of clinical factors are associated with recurrences, including co-occurring psychiatric and medical problems. Suicide is a major concern in the course of illness, so understanding risk factors may help mollify the likelihood of this outcome. Similarly, cardiovascular disease rates are elevated and associated with premature death. This chapter provides a review of the factors affecting and associated with bipolar disorder across the life span.

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Mood disorders in the elderly

New Oxford Textbook of Psychiatry ◽

10.1093/med/9780199696758.003.0201 ◽

2012 ◽

pp. 1550-1558

Author(s):

Robert Baldwin

Keyword(s):

Bipolar Disorder ◽

Mood Disorders ◽

Late Life ◽

Later Life ◽

The Elderly ◽

Clinical Syndrome ◽

Late Life Depression ◽

Increased Risk

This chapter considers some of the commonly asked questions about mood disorders in later life. Is depression in later life a distinct clinical syndrome? How common is it? Is there an organic link, for example to cerebral changes, and if so, is there an increased risk of later dementia? Is it more difficult to diagnose and treat late-life depression, and once treated, is the outcome good, bad, or indifferent? The emphasis will be on depression but bipolar disorder and mania will also be considered.

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Cardiovascular biomarkers predict fragility fractures in older adults

Heart ◽

10.1136/heartjnl-2018-313741 ◽

2018 ◽

Vol 105 (6) ◽

pp. 449-454 ◽

Cited By ~ 3

Author(s):

Madeleine Johansson ◽

Fabrizio Ricci ◽

Giuseppe Di Martino ◽

Cecilia Rogmark ◽

Richard Sutton ◽

...

Keyword(s):

Older Adults ◽

Femoral Fractures ◽

Fragility Fractures ◽

Population Based ◽

Community Dwelling ◽

Increased Risk ◽

Longitudinal Association ◽

History Of ◽

Neuroendocrine Activation

ObjectiveTo assess the role of four biomarkers of neuroendocrine activation and endothelial dysfunction in the longitudinal prediction of fragility fractures.MethodsWe analysed a population-based prospective cohort of 5415 community-dwelling individuals (mean age, 68.9±6.2 years) enrolled in the Malmö Preventive Project followed during 8.1±2.9 years, and investigated the longitudinal association between C-terminal pro-arginine vasopressin (CT-proAVP), C-terminal endothelin-1 precursor fragment (CT-proET-1), the mid-regional fragments of pro-adrenomedullin (MR-proADM) and pro-atrial natriuretic peptide (MR-proANP), and incident vertebral, pelvic and extremity fractures.ResultsOverall, 1030 (19.0%) individuals suffered vertebral, pelvic or extremity fracture. They were older (70.7±5.8 vs 68.4±6.3 years), more likely women (46.9% vs 26.3%), had lower body mass index and diastolic blood pressure, were more often on antihypertensive treatment (44.1% vs 38.4%) and had more frequently history of fracture (16.3% vs 8.1%). Higher levels of MR-proADM (adjusted HR (aHR) per 1 SD: 1.51, 95% CI 1.01 to 2.28, p<0.001) and MR-proANP (aHR: 1.23, 95% CI 1.05 to 1.45, p<0.001) were independently associated with increased risk of any fracture. The fracture risk increased linearly across MR-proANP quartiles. Individuals who were in the top quartile of all four biomarkers had a significant higher risk of fracture at any site (aHR: 2.32, 95% CI 1.86 to 2.91), vertebral fracture (aHR: 3.16, 95% CI 1.97 to 5.07) and femoral fracture (aHR: 2.35, 95% CI 1.64 to 3.36).ConclusionsElevated levels of MR-proADM and MR-proANP independently predict fragility fractures in older adults. In subjects with top quartile levels of all four biomarkers there is a twofold to threefold increase in risk of vertebral and femoral fractures.

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Pre-Eclamptic Pregnancies: An Opportunity to Identify Women at Risk for Future Cardiovascular Disease

Women s Health ◽

10.2217/17455057.4.2.133 ◽

2008 ◽

Vol 4 (2) ◽

pp. 133-135 ◽

Cited By ~ 25

Author(s):

Iasmina M Craici ◽

Steven J Wagner ◽

Suzanne R Hayman ◽

Vesna D Garovic

Keyword(s):

Systematic Review ◽

Cardiovascular Disease ◽

Risk Factor ◽

Meta Analysis ◽

Later Life ◽

Future Studies ◽

Increased Risk ◽

All Cause Mortality ◽

History Of

Evaluation of: Bellamy L, Casas JP, Hingorani AD, Williams DJ: Pre-eclampsia and risk of cardiovascular disease and cancer in later life: systematic review and meta-analysis. Br. Med. J. 335(7627), 974 (2007). Evidence has emerged over the years suggesting that women who develop hypertensive pregnancy disorders, most notably pre-eclampsia, are at an increased risk for cardiovascular disease later in life. In this study, a systematic review and meta-analysis were performed, assessing the future risks of cardiovascular disease, cancer and all-cause mortality in women with a history of pre-eclampsia and eclampsia. Women with a history of pre-eclampsia or eclampsia, compared with women without such a history, had an increased risk for cardiovascular disease, including a fourfold increased risk for hypertension, a twofold increased risk for ischemic heart disease, stroke and deep venous thrombosis, and a 1.5-times higher all-cause mortality. The study suggests that affected women may be eligible for preventive therapies at an earlier age, especially if future studies establish the role of pre-eclampsia as an independent cardiovascular risk factor.

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Cancer risk and impact of disease-modifying treatments in patients with multiple sclerosis

Multiple Sclerosis Journal ◽

10.1177/1352458507083625 ◽

2008 ◽

Vol 14 (3) ◽

pp. 399-405 ◽

Cited By ~ 58

Author(s):

Christine Lebrun ◽

Marc Debouverie ◽

Patrick Vermersch ◽

Pierre Clavelou ◽

Lucien Rumbach ◽

...

Keyword(s):

Breast Cancer ◽

Multiple Sclerosis ◽

Cancer Risk ◽

Digestive System ◽

Incidence Rates ◽

Incidence Of Cancer ◽

Increased Risk ◽

History Of ◽

Risk Of Cancer ◽

History Of Cancer

Background Prior to the era of immunomodulating or immunosuppressive (IS) treatments Multiple Sclerosis (MS) was linked to reduced rates of cancer. Method A descriptive study of MS patients with a documented oncological event was performed. From 1 January 1995 to 30 June 2006, we collected and studied the profile of 7418 MS patients gathered from nine French MS centers. We evaluated the incidence of cancer in a Cancer Risk In MS Cohort. Results Thirty one patients (1.75%) with confirmed MS had a history of cancer: mean age at MS diagnosis of 37.9 years and a mean age at cancer diagnosis of 46.4 years. The most frequent cancers were breast (34.5%), gynecological (12.5%), skin (10.2%), acute leukemia and lymphoma (5.9%), digestive (8.8%), kidney and bladder (5.1%), lung (3.4%) and central nervous system (3%). Calculated standardized incidence rates were 0.29 (0.17—0.45) for men and 0.53 (0.42—0.66) for women. The incidence of cancer in this MS population was lower than that expected for the general population. Matched to age, gender and histology, cancers in MS were associated with a young age and exposure to IS treatments. When considering all patients, treated patients had a 3-fold higher risk of developing cancer, if they had a history of IS ( P = 0.0035). For treated patients, the cancer sites were more likely the breast, the urinary tract, the digestive system and the skin. Conclusion Our data suggest that MS patients do not have an increased risk of cancer. Rather for several types of cancer a significantly reduced risk was observed, except for breast cancer in women treated with IS. The relative increased risk of breast cancer in MS women under IS treatment warrants further attention. Multiple Sclerosis 2008; 14: 399—405. http://msj.sagepub.com

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Frailty, depression, and anxiety in later life

International Psychogeriatrics ◽

10.1017/s1041610211002110 ◽

2012 ◽

Vol 24 (8) ◽

pp. 1265-1274 ◽

Cited By ~ 67

Author(s):

Aine M. Ní Mhaoláin ◽

Chie Wei Fan ◽

Roman Romero-Ortuno ◽

Lisa Cogan ◽

Clodagh Cunningham ◽

...

Keyword(s):

At Risk ◽

Older People ◽

Depression Scale ◽

Later Life ◽

Anxiety Symptoms ◽

Community Dwelling ◽

Anxiety And Depression ◽

Depression And Anxiety ◽

Increased Risk ◽

Clinically Significant

ABSTRACTBackground: Anxiety and depression are common in older people but are often missed; to improve detection we must focus on those elderly people at risk. Frailty is a geriatric syndrome inferring increased risk of poor outcomes. Our objective was to explore the relationship between frailty and clinically significant anxiety and depression in later life.Methods: This study had a cross-sectional design and involved the assessment of 567 community-dwelling people aged ≥60 years recruited from the Technology Research for Independent Living (TRIL) Clinic, Dublin. Frailty was measured using the Fried biological syndrome model; depressive symptoms were assessed using the Center for Epidemiological Studies Depression Scale; and anxiety symptoms measured using the Hospital Anxiety and Depression Scale.Results: Higher depression and anxiety scores were identified in both pre-frail and frail groups compared to robust elders (three-way factorial ANOVA, p ≤0.0001). In a logistic regression model the odds ratio for frailty showed a significantly higher likelihood of clinically meaningful depressive and anxiety symptoms even controlling for age, gender and a history of depression or anxiety requiring pharmacotherapy (OR = 4.3; 95% CI 1.5, 11.9; p = 0.005; OR = 4.36; 95% CI 1.4, 13.8; p = 0.013 respectively).Conclusions: Our findings suggest that even at the earliest stage of pre-frailty, there is an association with increased symptoms of emotional distress; once frailty develops there is a higher likelihood of clinically significant depression and anxiety. Frailty may be relevant in identifying older people at risk of deteriorating mental health.

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Mother-to-Infant Bonding in Women With a Bipolar Spectrum Disorder

Frontiers in Pediatrics ◽

10.3389/fped.2021.646985 ◽

2021 ◽

Vol 9 ◽

Author(s):

Myrthe G. B. M. Boekhorst ◽

Annemerle Beerthuizen ◽

Manon Hillegers ◽

Victor J. M. Pop ◽

Veerle Bergink

Keyword(s):

Bipolar Disorder ◽

Pregnant Women ◽

Population Based ◽

Spectrum Disorder ◽

Control Group ◽

Bipolar Spectrum ◽

Bipolar Spectrum Disorder ◽

Not Otherwise Specified ◽

Increased Risk ◽

History Of

Purpose: Offspring of mothers with a bipolar disorder are at high-risk for impaired developmental outcomes and psychopathology (e. g., mood, anxiety, sleep disorders) later in life. This increased risk of psychopathology is not only because of genetic vulnerability, but environmental factors may play an important role as well. The often long and debilitating mood episodes of mothers with bipolar disorder might hamper their qualities as a caregiver and may impact the child. We examined early mother-to-infant bonding 1 year postpartum in mothers with bipolar spectrum disorder as compared to mothers of the general population. The association between mother-to-infant bonding and the type of bipolar spectrum diagnosis (bipolar I, bipolar II, bipolar Not Otherwise Specified) as well as relapse within 12 months postpartum was also assessed.Methods: In total, 75 pregnant women with a bipolar spectrum disorder participated in the current study. The participants were included in a longitudinal cohort study of women with bipolar spectrum disorder and were prospectively followed from pregnancy until 1 year postpartum. Mother-to-infant bonding was assessed using the Pre- and Postnatal Bonding Scale. A longitudinal population-based cohort of 1,419 pregnant women served as the control group. Multiple linear regression analyses were used to assess the association between bipolar spectrum disorder and mother-to-infant bonding scores, controlling for several confounders.Results: Women with bipolar spectrum disorder perceived the bonding with their child as less positive compared to the control group. The type of bipolar spectrum disorder was not associated with poorer bonding scores. Relapse during the 1st year after delivery also did not affect bonding scores in women with bipolar spectrum disorder.Conclusions: Our findings could imply that women with bipolar spectrum disorder are more vulnerable to impairments in bonding due to the nature of their psychopathology, regardless of the occurrence of postpartum relapse. Careful follow-up including monitoring of mother-to-infant bonding of pregnant women with a history of bipolar spectrum disorder should be a standard to this vulnerable group of women. In addition, regardless of severity and mood episode relapse, an intervention to improve bonding could be beneficial for all mothers with bipolar spectrum disorder and their newborns.

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