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Medical Burden in Late-Life Bipolar and Major Depressive Disorders

From the Intervention Research Center for Late-Life Mood Disorders and the Advanced Center for Intervention and Services Research, Department of Psychiatry, the Bipolar Disorder Center for Pennsylvanians, University of Pittsburgh School of Medicine (AGG, EMW, RAD, IS, AF, AMK, PRH, CFR, EF, DJK, BHM); the Center for Health Equity Research and Promotion, VA Pittsburgh Healthcare System (AMK), Pittsburgh, PA; and the Centre for Addiction and Mental Health and the Department of Psychiatry (BHM), University of Toronto, Toronto, Ontario, Canada.

Background: Elderly patients with bipolar disorder have been found to have higher mortality than those with major depressive disorder. The authors compare medical burden in elderly patients with bipolar disorder with that in those with major depressive disorder.

Methods: Fifty-four patients with bipolar I or II disorder who were 60 years of age and older were equated 1-to-2 to 108 patients with nonpsychotic, major depressive disorder according to age, sex, race, and lifetime duration of mood disorder illness. Variables examined included the following: Cumulative Illness Rating Scale for Geriatrics (CIRS-G) total scores, body mass index (BMI), and CIRS-G subscale scores.

Results: Compared with patients with major depressive disorder, patients with bipolar disorder had similar levels of general medical comorbidity on the CIRS-G total score and number of systems affected but higher BMI. After controlling for multiple comparisons, the endocrine/metabolic and respiratory subscale scores on the CIRS-G were higher for patients with bipolar disorder.

Conclusion: Although overall medical burden appears comparable in elderly patients with bipolar and those with major depressive disorder, patients with bipolar disorder have higher BMI and greater burden of endocrine/metabolic and respiratory disease.

Key Words: bipolar disorder • major depressive disorder • medical comorbidity • aged