Senior’s Mental Health and Latent Stage in Bipolar Disorder

In the elderly, bipolar disorder (BD) often manifests as a complex psychiatric condition, leading to a host of medical complications and functional impairments. Though conversion rates from major depressive disorder (MDD) to BD remain lower in older adults compared to younger age groups, older adults who experience late-onset depression may be more at risk of converting from MDD to BD. Several risk factors are implicated in the conversion from MDD to BD, additionally impacting the course of latent-stage BD in the elderly. Such risks include a family history of BD, discontinuation of mood stabilizers (e.g., lithium), and cerebrovascular diseases. We encourage clinicians to be aware of the intricate nature of latent-stage BD in older adults as well as its symptom overlap with other cognitive disorders, such as behavioral frontotemporal dementia (bvFTD). However, there are distinguishing behavioral, cognitive, and neurophysiological factors that can assist one in differentiating between these conditions. More research is needed to examine the concept of latent-stage BD and its relevance to older populations.