Bipolar disorder symptoms in old age: gender and age differences network analysis

Abstract

The clinical presentation and course of illness of older-age bipolar disorder (OABD) are highly variable. In addition, the presentation and course of bipolar disorder (BD) differ between females and males. This study aims to carry out a network analysis of older people with symptoms compatible with BD. Using a sample from the MentDis_ICF65+ study, a symptom network analysis was conducted according to gender and age in 555 people over 65 in the Community of Madrid (Spain). The network was estimated using the InsingFit package that implements a procedure called eLasso. These results reveal differences in the strength, closeness, and betweenness of the networks according to gender and for the age groups 65–74 and 75–84. Females present a network that is much more sparse, with a lower density, and consisting of two sub-networks: one composed of TALK (more talkative than usual) and RACIN (a flight of ideas, racing thoughts) and the other of PAINF (activities with painful consequences), SLEEP (the decreased need for sleep), GRAND (inflated self-esteem), and AGIT (psychomotor agitation). In the case of men, a denser network is obtained, with greater connections between all the symptoms, being the edge with greater weight than the one integrated by RACIN and GRAND. In relation to age, it is possible to observe changes in the model between the two age groups. These network differences support viewing OABD dimensionally and emphasize considering gender and age to improve understanding and personalize treatments for older adults with bipolar disorder symptoms.