Objective:To review the evidence base regarding presentation of mania and bipolar disorders in the elderly.
Design and Methods: Literature review.
Results:The differential diagnosis of manic and mixed states in the elderly is broad. The psychopathology associated with mania is disruptive, and can include aggression and lack of insight. Psychotic features can be present. Little is known about type II bipolar disorder or bipolar depression in late life. Mania can occur in patients with dementia, but the overlap between bipolar disorders and dementias is poorly understood. Impairments of cognitive performance are common in aged bipolar patients; although improvement in cognitive performance can be expected with remission, enduring deficits are also observed. Longitudinal assessment can be critical to assessment.
Conclusion: These patients are remarkably heterogeneous and have severe illness. The literature describing these patients remains limited.
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