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13-08-2013 | Mental health | Article

More research needed on late-life mania


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medwireNews: Mania is relatively common among psychiatric inpatients older than 50 years, many of whom are experiencing such symptoms for the first time, say researchers.

“The fact that mania in older adults is more common than previously assumed emphasizes the need for research targeting the nature of manic symptoms in this specific population,” say study author Annemiek Dols (VU University Medical Center, Amsterdam, the Netherlands) and team.

“There is still insufficient knowledge about the specific symptom profile, the long-term history of affective symptoms that precede a manic presentation, the role of family history, and the precise effects of somatic comorbidity.”

The researchers identified 18 studies that reported the prevalence of mania in people older than 50 years, most of which reported on inpatients. Six studies focused on general psychiatric inpatients, and reported an average mania prevalence of 6.0%.

Among a further six inpatient studies that focused on bipolar disorder, the rate of first-time mania, reported in three studies, ranged from 28% to 53%.

The findings suggest that “late-onset mania is a frequent condition in clinical settings,” say Dols and team. “Overall, the mean percentages in our review translate to a number of six manic patients in every 100 admissions to a psychogeriatric unit, of whom two to three patients are experiencing a first manic episode.”

Only one study reported on patients in nursing homes, finding a mania prevalence of 1.6%. “Clearly, larger studies are needed to confirm the prevalence of psychiatric symptoms in non-demented people living in residential facilities where psychiatric care is often scarce,” comment Dols et al in Bipolar Disorders.

They also identified just one study looking at community-dwelling older adults, which reported a mania prevalence of 0.6%. This is higher than previously published prevalence rates of bipolar disorder in the over-65s (0.1–0.4%), say the researchers, suggesting that some mania in this age group arises from causes other than bipolar disorder.

medwireNews ( is an independent clinical news service provided by Springer Healthcare Limited. © Springer Healthcare Ltd; 2013

By Eleanor McDermid, Senior medwireNews Reporter