Demographic and Clinical Characteristics of Lithium-Treated Older Adults With Bipolar Disorder: A Replication Study From the Global Aging and Geriatric Experiments in Bipolar Disorder (GAGE-BD) Project

Acta Psychiatr Scand. 2025 Nov;152(5):393-396. doi: 10.1111/acps.70016. Epub 2025 Jul 10.

Abstract

Objectives: To replicate a previous study addressing differences and similarities of older adults with bipolar disorder (OABD) treated with lithium as compared to those treated with other drugs.

Methods: Cross-sectional analysis of a harmonized dataset of the GAGE-BD Project, with over 2 thousand participants enrolled from two recruitment waves, with worldwide representation. Participants were allocated in two treatment groups according to the availability of information about current lithium use (Lithium, n = 754; Non-lithium, n = 1,161). We used linear regression, linear mixed and generalized linear mixed models to examine the associations between treatment groups and other variables, with emphasis on the distribution of socio-demographical and clinical variables, controlling for age, gender, and study site.

Results: We found statistical associations between lithium use and higher education level, as well as with bipolar-1 subtype, and a negative association with comorbid anxiety disorder. OABD patients treated with lithium had lower scores on depression rating scales, and better overall global cognitive and functional state. Lithium users also reported having fewer cardiovascular comorbidities.

Conclusion: We found several potentially relevant differences in the clinical profile of OABD treated with lithium; nonetheless, the interpretation of the present results must take into account the methodological limitations inherent to the cross-sectional approach and data harmonization.

Keywords: OABD; bipolar disorder; elderly; lithium; older age bipolar disorder; pharmacology.

MeSH terms

  • Aged
  • Antimanic Agents* / therapeutic use
  • Anxiety Disorders / epidemiology
  • Bipolar Disorder* / drug therapy
  • Bipolar Disorder* / epidemiology
  • Bipolar Disorder* / psychology
  • Comorbidity
  • Cross-Sectional Studies
  • Female
  • Humans
  • Lithium Compounds* / therapeutic use
  • Male
  • Middle Aged

Substances

  • Lithium Compounds
  • Antimanic Agents