BACKGROUND: By 2030, over 50% of individuals living with bipolar disorder (BD) are expected to be aged ≥50 years. However, older age bipolar disorder (OABD) remains understudied. There are limited large-scale prospectively collected data organized in key dimensions capable of addressing several fundamental questions about BD affecting this subgroup of patients. METHODS: We developed initial recommendations for the essential dimensions for OABD data collection, based on (1) a systematic review of measures used in OABD studies, (2) a Delphi consensus of international OABD experts, (3) experience with harmonizing OABD data in the Global Aging & Geriatric Experiments in Bipolar Disorder Database (GAGE-BD, n ≥ 4500 participants), and (4) critical feedback from 34 global experts in geriatric mental health. RESULTS: We identified 15 key dimensions and variables within each that are relevant for the investigation of OABD: (1) demographics, (2) core symptoms of depression and (3) mania, (4) cognition screening and subjective cognitive function, (5) elements for BD diagnosis, (6) descriptors of course of illness, (7) treatment, (8) suicidality, (9) current medication, (10) psychiatric comorbidity, (11) psychotic symptoms, (12) general medical comorbidities, (13) functioning, (14) family history, and (15) other. We also recommend particular instruments for capturing some of the dimensions and variables. CONCLUSION: The essential data dimensions we present should be of use to guide future international data collection in OABD and clinical practice. In the longer term, we aim to establish a prospective consortium using this core set of dimensions and associated variables to answer research questions relevant to OABD.

Amsterdam UMC Vrije Universiteit Psychiatry Amsterdam Public Health Research Institute Amsterdam Neuroscience Amsterdam The Netherlands

Bipolar and Depressive Disorders Unit Hospital Clinic University of Barcelona IDIBAPS CIBERSAM Barcelona Catalonia Spain

Department of Clinical Neuroscience Centre for Psychiatric Research and Education Karolinska Institutet Solna Sweden

Department of Geriatric Psychiatry Department of Psychiatry Jewish General Hospital Lady Davis Institute McGill University Montreal Quebec Canada

Department of Old Age Psychiatry GGZ inGeest Amsterdam The Netherlands

Department of Population and Quantitative Health Sciences Case Western Reserve University School of Medicine Cleveland Ohio USA

Department of Psychiatry and Behavioral Neurosciences McMaster University St Joseph's Healthcare Hamilton Hamilton Ontario Canada

Department of Psychiatry and Behavioral Sciences University of Texas McGovern Medical School Houston Texas USA

Department of Psychiatry Dalhousie University Halifax Nova Scotia Canada

Department of Psychiatry School of Medicine College of Medicine Taipei Medical University Taipei Taiwan

Department of Psychiatry University Medical Center Groningen University of Groningen Groningen The Netherlands

Department of Psychiatry University of California San Diego San Diego California USA

Department of Psychiatry University of Oxford Oxford UK

Department of Psychiatry University of Sao Paulo São Paulo Brazil

Department of Psychiatry University of Toronto Center for Addiction and Mental Health Toronto Ontario Canada

Department of Psychiatry Yale School of Medicine New Haven Connecticut USA

Departments of Psychiatry and of Neurology Case Western Reserve University School of Medicine University Hospitals Cleveland Medical Center Cleveland Ohio USA

Desert Pacific Mental Illness Research Education and Clinical Center VA San Diego Healthcare System San Diego California USA

Division of Geriatric Psychiatry McLean Hospital Belmont Massachusetts USA

Division of Geriatric Psychiatry McLean Hospital Harvard Medical School Boston Massachusetts USA

Faillace Department of Psychiatry and Behavioral Sciences McGovern Medical School UTHealth Houston Texas USA

Federal Neuro psychiatric Hospital Yaba Lagos Nigeria

Institute of Psychiatry Psychology and Neuroscience King's College London London UK

Laboratório Interdisciplinar de Investigação Médica da Faculdad de Medicina Universidad Federal de Minas Gerais Belo Horizonte Brazil

Laboratory of Neuroscience Department and Institute of Psychiatry HCFMUSP Faculdad de Medicina da Universidad de São Paulo São Paulo Brazil

Medical Faculty Bipolar Center Wiener Neustadt Sigmund Freud University Wien Austria

Medical School University of Western Australia Perth Western Australia Australia

National Institute of Mental Health Klecany Czech Republic

Selçuk University Medical Faculty Department of Psychiatry Mazhar Osman Mood Clinic Konya Turkey

Teaching Unit of Psychiatry and Psychological Medicine Department of Medicine University of Valencia CIBERSAM Valencia Spain

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