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首页> 外文期刊>International journal of geriatric psychiatry >Older men with bipolar disorder: Clinical associations with early and late onset illness
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Older men with bipolar disorder: Clinical associations with early and late onset illness

机译：具有双相情感的老年人：临床关联早期和晚期发病疾病

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Objectives Older adults living with bipolar disorder (BD) include people with early and late onset of symptoms. This study aimed to clarify the cross‐sectional and longitudinal clinical associations of BD with early and late onset. Methods Cohort study of 38?173 men aged 65–85?years followed for up to 17.6?years. We used the Western Australian Data Linkage System to establish the presence of BD, as well as diabetes, cardiovascular and renal diseases, cancer, respiratory and gastrointestinal diseases, alcohol use disorder, dementia, and mortality. The causes of death were recorded according to the International Classification of Diseases. We defined late onset BD using 2 different cut‐points: 50 and 60?years. Results The prevalence of medical morbidities was greater among participants with than without BD, and cardiovascular diseases were more frequent among those with onset before than after 50?years (odds ratio?=?1.72, 95% confidence interval?=?1.01, 2.94). Bipolar disorder was associated with increased hazard ratio of dementia and death, but there was no difference between early and late onset participants. Death by suicide or accidents occurred exclusively among BD participants with illness onset 60?years, whereas death associated with strokes and neurodegenerative diseases was more frequent among those with illness onset ≥60?years than in the general population (HR?=?2.28, 95% confidence interval?=?1.34, 3.88). Conclusions Our results indicate that the clinical associations and outcomes of older adults living with BD are not markedly influenced by age of onset. However, mortality data suggest that differences between older adults with BD onset before and after age 60?years should continue to be explored.
机译：目标与双相情感障碍（BD）一起生活的老年人包括早期和症状发作的人。本研究旨在阐明BD的横截面和纵向临床关联，早期和晚期发作。方法队列研究38？173男性65-85岁以下的男性，持续最多17.6岁。我们利用西澳大利亚数据联动系统建立了BD的存在，以及糖尿病，心血管和肾病，癌症，呼吸系统和胃肠疾病，酒精使用障碍，痴呆和死亡率。根据国际疾病分类记录死亡原因。我们使用2个不同的切割点定义了晚期发作BD：50和60？年。结果除了没有BD的参与者的参与者中，医学病理的患病率更大，并且在50岁以下（差距率Δ= 1.72,95％置信区间？=？1.01,2.94）中，心血管疾病比在50岁以后更频繁。双相情感障碍与痴呆和死亡的危害率增加有关，但早期和晚期参与者之间没有差异。自杀或事故的死亡仅发生在BD参与者中，患有疾病发病的BD参与者，而与中风和神经退行性疾病相关的死亡在患有患病≥60的人中比一般人群更频繁（HR？=？2.28 ，95％置信区间？=？1.34,3.88）。结论我们的结果表明，与BD的老年人的临床关联和结果对发病年龄没有明显影响。然而，死亡数据表明，在60岁之前和之后BD发作的老年人之间的差异应该继续探讨。

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