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An epidemiological profile of bipolar disorder among older adults with complex needs: A national cross‐sectional study
Author(s) -
Schluter Philip J,
Lacey Cameron,
Porter Richard J,
Jamieson Hamish A
Publication year - 2017
Publication title -
bipolar disorders
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.285
H-Index - 129
eISSN - 1399-5618
pISSN - 1398-5647
DOI - 10.1111/bdi.12511
Subject(s) - medicine , confidence interval , epidemiology , odds ratio , logistic regression , cross sectional study , bipolar disorder , ethnic group , demography , gerontology , psychiatry , pathology , sociology , anthropology , cognition
Objectives Research on bipolar disorder ( BD ) among community‐living older adults is scant and often suffers from important methodological limitations. Using a national database, this study presents an epidemiological profile of BD in older community residents within New Zealand. Methods Since 2012, all New Zealand community care recipients have undergone a standardized needs assessment using the Home Care International Residential Assessment Instrument (inter RAI ‐ HC ). The inter RAI ‐ HC elicits information using 236 questions over 20 domains, including BD diagnosis. Those who were assessed between 1 September 2012 and 31 January 2016, who were aged ≥65 years, and who provided consent were included. Statistical investigations employed bivariable and multivariable logistic regression models. Results Overall, 71 859 people were eligible; their average age was 82.7 years (range 65‐105 years), with 43 802 (61.0%) being female and 798 (1.1%) having a BD diagnosis. Participants' sex, age and ethnic identification were significantly related to BD (all P <.001). Participants with a higher number of comorbidities had greater odds of BD ; for those with at least six comorbidities, the adjusted odds ratio ( AOR ) was 2.32 (95% confidence interval [ CI ] 1.37‐3.92). Almost all considered social and environmental variables were significantly and detrimentally associated with BD , such as living in squalid conditions (2.7% for those with DB vs 1.1% for those without DB; AOR =1.60 [95% CI 1.06‐2.42]). Conclusions BD among older adults is not uncommon, and numbers will increase as populations age. Increasingly, health services are moving to home‐based integrated models of care. Clinicians and decision‐makers need to be aware in their planning and service delivery that significant deficits in environment quality and exposure to stressful living circumstances remain for older adults with BD .