Discuss a chronic mental health condition in the geriatric population. Include specific age considerations related to diagnosis, treatment, prognosis, and quality of life
Discuss a chronic mental health condition in the geriatric population. Include specific age considerations related to diagnosis, treatment, prognosis, and quality of life
DQ Question
Late-onset Bipolar disorder (LOBI) is diagnosed among older adults 65 years and older. The clinical presentation of LOBI seems to be almost similar to that of early-onset Bipolar. However, LOBI has higher premorbid psychosocial functioning and less severe psychopathology (Salem et al., 2018). Old age has a negative or low association with various elements, including activity‐energy score, religiosity, sexual interest, and initiating and developing plans. The atypical clinical presentation of late‐onset bipolar II disorder includes mood reactivity, hypersomnia, increased appetite or weight gain, leaden paralysis, and a persistent pattern of severe sensitivity to perceived interpersonal rejection (Salem et al., 2018). These features are less prevalent in earlier‐onset Bipolar.
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Clinicians managing older adults with LOBD must take into account the various aspects that differentiate the clinical features of Bipolar disorder in old age from features in the younger population. They should also consider the special aspects of somatic gerontology. In the pharmacological treatment of older adults with Bipolar disorder, clinicians should consider age-related changes in pharmacokinetic and pharmacodynamic properties of drugs like protein binding, distribution volume, and metabolism 9Ljubic et al., 2021). Older adults have altered cellular functions causing decreased enzyme activities. Therefore, lower drug dosages are recommended to accommodate these changes.
Regarding LOBI prognosis, substantial evidence shows a gradual and deteriorating course over a life span. Older adults exhibit an increasing sensitization that causes more relapses after each mood episode. Arnold et al. (2021) explain that the rates of psychiatric admission appear to reduce in LOBI patients. This is because the severity of ensuing episodes decreases and suicide rates lessen, which is probably because elderly patients represent, to some extent, a selected survival cohort. Furthermore, geriatrics who receive psychosocial interventions exhibit an improved quality of life.
References
Arnold, I., Dehning, J., Grunze, A., & Hausmann, A. (2021). Old Age Bipolar Disorder-Epidemiology, Aetiology and Treatment. Medicina (Kaunas, Lithuania), 57(6), 587. https://doi.org/10.3390/medicina57060587
Ljubic, N., Ueberberg, B., Grunze, H., & Assion, H. J. (2021). Treatment of bipolar disorders in older adults: a review. Annals of General Psychiatry, 20(1), 1-11. https://doi.org/10.1186/s12991-021-00367-x
Salem, A., Shah, N., Geraldi-Samara, D., Elangovan, N., & Krzyzak, M. (2018). Late-onset Bipolar I Disorder. Cureus, 10(8), e3242. https://doi.org/10.7759/cureus.3242
Discuss a chronic mental health condition in the geriatric population. Include specific age considerations related to diagnosis, treatment, prognosis, and quality of life. Support your answer with a minimum of two APRN peer-reviewed resources.
DO NOT USE DEPRESSION, ANXIETY, DEMENTIA, SUBSTANCE ABUSE, SCHIZOPHRENIA