Comparing 8-Year Survival Rates in Older-Age Bipolar Disorder (OABD) and Its Clinical Predictors to the General Population.
w?>Bipolar disorder (BD) is associated with reduced life expectancy, but it is unknown if this extends into later life or if older-age bipolar disorder (OABD) represents a survival cohort.
In this prospective cohort study, 227 adults aged ≥50 years with BD from the Dutch Older Bipolars (DOBi) study were compared with 681 matched (on age and sex) controls (CG) from the Longitudinal Aging Study Amsterdam (LASA). All-cause mortality was assessed over 8 years. Kaplan-Meier survival, restricted mean survival time, and Cox proportional hazards models were applied.
In total, 37 (16.3%) OABD and 138 (20.3%) CG participants died during the 8-year follow-up. Kaplan-Meier curves indicated earlier mortality in OABD. Restricted mean survival time over 7.5 years was 2500.7 days (95% confidence interval [CI] 2419.9-2581.5) in OABD and 2607.2 days (95% CI 2572.3-2642.0) in CG, corresponding to an average survival difference of 106.4 days (3.5 months; 95% CI 18.4-194.5; p = 0.018). In Cox models, OABD was associated with higher mortality risk compared with CG (hazard ratio (HR) = 1.72; 95% CI 1.17-2.54; p = 0.006).
In this longitudinal cohort study, OABD had significantly higher all-cause mortality than age- and sex-matched population controls, with a shorter restricted mean survival time and an increased hazard of death over 8 years. Thus, excess mortality persists into later life, and OABD is not solely a survivor cohort. Targeted strategies addressing modifiable physical health and lifestyle risk factors are warranted to reduce premature mortality in this vulnerable population.
In this prospective cohort study, 227 adults aged ≥50 years with BD from the Dutch Older Bipolars (DOBi) study were compared with 681 matched (on age and sex) controls (CG) from the Longitudinal Aging Study Amsterdam (LASA). All-cause mortality was assessed over 8 years. Kaplan-Meier survival, restricted mean survival time, and Cox proportional hazards models were applied.
In total, 37 (16.3%) OABD and 138 (20.3%) CG participants died during the 8-year follow-up. Kaplan-Meier curves indicated earlier mortality in OABD. Restricted mean survival time over 7.5 years was 2500.7 days (95% confidence interval [CI] 2419.9-2581.5) in OABD and 2607.2 days (95% CI 2572.3-2642.0) in CG, corresponding to an average survival difference of 106.4 days (3.5 months; 95% CI 18.4-194.5; p = 0.018). In Cox models, OABD was associated with higher mortality risk compared with CG (hazard ratio (HR) = 1.72; 95% CI 1.17-2.54; p = 0.006).
In this longitudinal cohort study, OABD had significantly higher all-cause mortality than age- and sex-matched population controls, with a shorter restricted mean survival time and an increased hazard of death over 8 years. Thus, excess mortality persists into later life, and OABD is not solely a survivor cohort. Targeted strategies addressing modifiable physical health and lifestyle risk factors are warranted to reduce premature mortality in this vulnerable population.
Authors
Bayat Bayat, Hoogendoorn Hoogendoorn, Schwellnus Schwellnus, van Exel van Exel, Al Kok Al Kok, Korten Korten, Schouws Schouws, Orhan Orhan, Dols Dols
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