''Does bipolar disorder accelerate cellular aging? A systematic review and meta-analysis of telomere length''.

Clinical Characteristics and Health Service Use of Veterans With Comorbid Bipolar Disorder and PTSD

Age moderates the relationship between affective response inhibition and bipolar disorder in adults

Objective:Bipolar disorder (BD) has been associated with increased rates of age-related diseases, such as type II diabetes, metabolic syndrome, osteoporosis, and cardiovascular disorders. Several biological findings have been associated with age-related disorders, including increased oxidative stress, inflammation, and telomere shortening. The objective of this study was to compare telomere length among participants with BD at early and late stages and age- and gender-matched healthy controls.Methods:Twenty-six euthymic subjects with BD and 34 healthy controls were recruited. Genomic DNA was extracted from peripheral blood and mean telomere length was measured using real-time quantitative polymerase chain reaction.Results:Telomere length was significantly shorter in both the early and late subgroups of BD subjects when compared to the respective controls (p = 0.002 and p = 0.005, respectively). The sample size prevented additional subgroup analyses, including potential effects of medication, smoking status, and lifestyle.Conclusion:This study is concordant with previous evidence of telomere shortening in BD, in both early and late stages of the disorder, and supports the notion of accelerated aging in BD.

Accelerated aging in bipolar disorder: A comprehensive review of molecular findings and their clinical implications

Eotaxin-1/CCL11 correlates with left superior temporal gyrus in bipolar disorder: A preliminary report suggesting accelerated brain aging

Correlation between amygdala volume and age in bipolar disorder — A systematic review and meta-analysis of structural MRI studies

Genome-wide methylation biomarkers and biological aging in patients with bipolar disorder characterized for lithium response.

The 10–15-years decrease in life expectancy observed in individuals with bipolar disorder (BD) has been linked to the concept of accelerated cellular aging. Telomere length (TL) and mitochondrial DNA copy number (mtDNAcn) have been proposed as markers of cellular aging and comparisons between individuals with BD and healthy controls (HC) sometimes led to conflicting results. Previous studies had moderate sample sizes and studies combining these two markers into a single analysis are scarce. Using quantitative polymerase chain reaction, we measured both TL and mtDNAcn in DNA (peripheral blood) in a sample of 130 individuals with BD and 78 HC. Regression analyses, receiver operating characteristic (ROC), and clustering analyses were performed. We observed significantly lower TL and mtDNAcn in individuals with BD as compared to HC (respective decrease of 26.5 and 35.8%). ROC analyses showed that TL and mtDNAcn highly discriminated groups (AUC = 0.904 for TL and AUC = 0.931 for mtDNAcn). In the whole population, clustering analyses identified a group of young individuals (age around 36 years), with accelerated cellular aging (both shorter TL and lower mtDNAcn), which consisted mostly of individuals with BD (85.5%). The subgroup of patients with young age but accelerated aging was not characterized by specific clinical variables related to the course of BD or childhood maltreatment. However, patients in this subgroup were more frequently treated with anticonvulsants. Further characterization of this subgroup is required to better understand the molecular mechanisms and the risk factors of accelerated cellular aging in BD.

Bipolar disorder is a common condition diagnosed by the occurrence of pathological mood elevation but most often dominated by dysphoria states. Over the past 10 years, understanding of bipolar disorder and the number of evidence-based treatments have increased dramatically. This article offers strategies for improving diagnostic confidence and simple benchmarks that facilitate integrating principles of evidence-based medicine into the management of patients with bipolar disorder. Simple systematic assessment techniques such as focusing the evaluation to assess the most extreme episode of mood elevation and longitudinal factors such as age of onset and course of illness can avoid errors of omission and raise diagnostic confidence. An iterative measurement-based treatment model that aims to bring patients and their supports into the collaborative care process for progressively better outcomes is recommended.

Accelerated aging in bipolar disorders: An exploratory study of six epigenetic clocks

Links between objective sleep and sleep variability measures and inflammatory markers in adults with bipolar disorder

This study tested the hypothesis that patients with comorbid bipolar and substance use disorders use health services to a greater extent than patients with either bipolar or substance use disorder alone. A retrospective chart review was conducted among patients who used health services at the Ralph H. Johnson Department of Veterans Affairs medical center in Charleston, South Carolina, and had bipolar disorder alone, substance use disorder alone, and comorbid bipolar and substance use disorders. Patients with a psychiatric admission between 1999 and 2003 were included in the study. Information was collected on the use of health services one year before and including the index admission. The records of 106 eligible patients were examined for this study: 18 had bipolar disorder alone, 39 had substance use disorder alone, and 49 had both bipolar and substance use disorders. Compared with the other two groups, the group with comorbid bipolar and substance use disorders was significantly more likely to be suicidal. Compared with the group with bipolar disorder alone, the group with comorbid disorders had significantly fewer outpatient psychiatric visits and tended to have shorter psychiatric hospitalizations. Among patients with an alcohol use disorder, those who also had bipolar disorder were significantly less likely than those with an alcohol use disorder alone to have had an alcohol-related seizure. Patients with comorbid bipolar and substance use disorders were significantly less likely than those with substance use disorder alone to be referred for intensive substance abuse treatment, even though both groups were equally likely to enter and complete treatment when they were referred. Despite significant functional impairment among patients with comorbid bipolar and substance use disorders, they had significantly fewer psychiatric outpatient visits than those with bipolar disorder alone and were referred for intensive substance abuse treatment significantly less often than those with substance use disorder alone.

BackgroundEating disorders (ED) are noted to occur with bipolar disorder (BD), but relationships between additional comorbidities, clinical correlates, and personality factors common to both remain largely unknown.MethodsUsing data from the Prechter Longitudinal Study of Bipolar Disorder, we measured the prevalence and demographic factors of comorbid ED with BD, presence of additional comorbidity of anxiety and substance use disorders, psychosis, suicide attempts, mixed symptoms, childhood abuse, impact of NEO-Personality Inventory (NEO-PI) personality factors, and mood outcome in 354 patients with BD. We analyzed the prevalence of ED using both broad and narrow criteria.Results and discussionED was more common in the Prechter BD sample than the general population, with the majority of those with ED being female. Anxiety disorders, alcohol abuse/dependence, and NEO-PI N5 impulsiveness were independently associated with ED in a multivariable linear regression analysis. BD age at onset was earlier in the ED group than that in the non-ED group and was earlier than the average onset of ED. Anxiety occurred before ED and alcohol use disorders after both BD and ED. Childhood trauma was associated with ED. Impulsivity and anxiety associated with BD may fuel ED and put patients at risk for other impulsivity-related disorders such as alcohol use disorders. ED was associated with more severe and variable moods and more frequent depression. Patients with BD should be regularly screened for ED, anxiety disorders, and alcohol use disorders, and comorbidity should be promptly addressed.

BackgroundCognitive aging is a known phenomenon in individuals with bipolar disorder (BD), but the underlying biological mechanisms responsible for this cognitive decline remain poorly understood. One potential avenue of investigation is the dysfunction of the Klotho/Fibroblast Growth Factor 23 (FGF23) system, which has been linked to reduced lifespan and age-related diseases, including dementia. However, there is limited research on the relationship between Klotho/FGF23 levels and aging in BD patients, as well as their association with cognitive decline in elderly individuals with BD.AimsThe aim of this study was to explore the levels of Klotho and FGF23 in elderly BD patients and their relationship with the aging profile and cognitive domains.MethodsThe study included 85 euthymic, elderly participants aged 50 or older, who also had adequate kidney function and were diagnosed with BD-I. Cognitive function was assessed using the Brief Assessment of Cognition in Affective Disorders. The study examined the correlations between Klotho and FGF23 levels and other aging-related assessments. General linear models were then used to identify associations between Klotho and FGF23 levels and various cognitive domains.ResultsThe average age of the participants was 59.64 years. The mean Klotho and FGF23 levels were 0.71 ng/ml and 15.02 ng/ml, respectively. Positive correlations were found between Klotho and FGF23 (r= 0.352, p = 0.002) and between creatine levels and Klotho/FGF23 (r = 0.328, p = 0.016 for Klotho and r= 0.302, p = 0.028 for FGF23). Higher levels of FGF23 were significantly associated with lower composite cognitive scores (β= -0.003, p = 0.005), particularly in verbal memory (β= -0.002, p = 0.013), motor speed (β= -0.002, p = 0.027), and processing speed (β= -0.002, p = 0.029). No significant association was observed between Klotho levels and cognitive domains.ConclusionIn elderly individuals with BD, this study found that higher FGF23 levels were associated with negative effects on cognitive domains, particularly in verbal memory, motor speed, and processing speed. However, no significant association was found between Klotho levels and cognitive performance. Future research is needed to further define the dysfunction of the Klotho/FGF23 axis and conduct longitudinal studies that incorporate validated aging clinical markers to better understand the underlying mechanisms of cognitive aging in BD.

Preliminary evidence suggests that premature immunosenescence is involved in bipolar disorder (BD) pathophysiology. The cellular marker CD69 is expressed in T lymphocyte surface during their activation and its expression is negatively correlated with age. The objective of this study was to assess the moderating effects of obesity on the reduction of expression of CD69, a marker of immunosenescence. Forty euthymic patients with BD type I, aged 18–65 years, were included in this study. The healthy comparison group consisted of 39 volunteers who had no current or lifetime history of mental disorders, no use of psychotropic medications, and no known family history of mood disorders or psychosis. Peripheral blood mononuclear cells from BD patients and healthy controls were collected and isolated. The cells were allowed to grow in culture and stimulated for 3 days. CD69 was marked and read in flow cytometry. We found that the lower expression of CD69 in BD patients was moderated by body mass index (BMI) in both CD4+ (RR = 0.977, 95% CI 0.960–0.995, p = 0.013) and CD8+ cells (RR = 0.972, 95% CI 0.954–0.990, p = 0.003). Our findings indicate that BMI could potentially influence the process of premature aging in BD.