TOPLINE

Bipolar disorder (BD) was associated with significantly higher all-cause mortality over 8 years of follow-up in older adults than in age- and sex-matched individuals from the general population, with mean survival time shortened by more than 3 months, a new cohort study showed.

METHODOLOGY

• A prospective cohort study compared 227 older adults with BD from the Dutch Older Bipolar study to 681 age- and sex-matched control individuals from the Longitudinal Aging Study Amsterdam study in the Netherlands.
• Participants with BD were recruited from a mental health facility in Amsterdam between 2011-2012 (wave 1; n = 101; aged ≥ 60 years) and 2017-2018 (wave 2; n = 126; aged ≥ 50 years).
• The primary outcome was all-cause mortality, with a maximum follow-up of 8 years. Participants who were alive beyond 8 years were administratively censored at that timepoint.

TAKEAWAY

• During 8 years of follow-up, 16.3% of the BD group and 20.3% of the control group died, with analysis indicating earlier mortality in those with BD. Although cumulative death percentages were lower in the BD group, this may be due to administrative censoring, the researchers reported.
• In unadjusted analysis, participants with BD had a higher risk for mortality than control individuals (hazard ratio [HR], 1.65; P = .01), with the association remaining significant even after adjustment for age and sex (HR, 1.72; P = .006).
• The restricted mean survival time over 7.5 years was 2500.7 days in the BD group vs 2607.2 days in the control group (average difference, 106.4 days; P = .02).
• In the BD group, causes of death were cancer (35.1%), heart failure (10.8%), multiorgan failure (10.8%), suicide (2.7%), or other causes (40.6%), including one COVID-related death.

IN PRACTICE

“This study provides evidence that mortality remains elevated in BD well into later life, even among those receiving ongoing mental health treatment, underscoring the need for early identification, proactive monitoring, and targeted interventions to mitigate excess mortality in this vulnerable population,” the investigators wrote.

SOURCE

The study was led by Nazila Bayat, MD, GGZ inGeest, Amsterdam. It was published online on July 21 in The American Journal of Geriatric Psychiatry.

LIMITATIONS

The median survival time could not be estimated, data on the causes of death in individuals in the control group were unavailable, and functional status could not be compared across groups. Additionally, residual confounding could not be ruled out and generalizability to other healthcare systems might be limited.

DISCLOSURES

The study received no external funding. The investigators reported no relevant conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.