Etiology and epidemiological correlates of borderline personality disorder in older adults

Personality disorders are considered to be life-long and are modulated by interactions between the individual and the environment. However, personality disorders have not been well studied in later stages of life. In the case of borderline personality disorder (BPD), there has been much advance in early to mid-life epidemiology and phenomenology but relatively little is known about BPD in geriatric patients (i.e., aged 65 years and older). A number of retrospective studies have been conducted with the attendant limitations in reliability. More recently, prospective follow-up studies have been conducted but the mean age of participants remains relatively young as they capture patients primarily in early to late middle age. This paucity of research is problematic in that descriptive research and clinical experience show that the core features of BPD continue to be disabling and can be quite disruptive in nursing homes, inpatient geriatric units and other geriatric service delivery settings. This section will summarize the etiology and epidemiological correlates of BPD as it pertains to older adults.