{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T03:48:50Z","timestamp":1777866530803,"version":"3.51.4"},"reference-count":53,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T00:00:00Z","timestamp":1777507200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T00:00:00Z","timestamp":1777507200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Int J Geriat Psychiatry"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Bipolar disorder (BD) in older adults is linked to significant medical comorbidities and hospitalization burden, yet nationwide data remain scarce. This study aims to compare younger versus older BD hospitalization trends, patient characteristics, and the impact of comorbidities on hospitalization outcomes in Portugal (2008\u20132015).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective observational study was conducted using a Portuguese administrative database, selecting hospitalization episodes of patients aged \u2265 60\u00a0years with a primary BD diagnosis. Variables analyzed included demographics, psychiatric comorbidities, Charlson Comorbidity Index (CCI), length of stay (LoS), in\u2010hospital mortality, hospital charges, and readmissions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      <jats:italic>From a total of 21<\/jats:italic>\n                      ,\n                      <jats:italic>793 BD hospitalizations<\/jats:italic>\n                      , there were 4801 (22.0%) BD\u2010related hospitalizations in the older age group, and the annual hospitalization rate was 23.4 per 100,000 inhabitants. The median admission age was 66.0\u00a0years, and 67.7% were female. BD type I with a manic episode (32.9%) was the most frequent subtype, and 85.5% of admissions were emergent. The median LoS was 18.0\u00a0days, significantly longer than in younger adults (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.001). Readmission occurred in 52.4% of cases, with in\u2010hospital mortality at 0.7%. Comorbidities were present in 23.0% of hospitalizations, with diabetes (13.1%) and dementia (3.2%) being most prevalent.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Limitations<\/jats:title>\n                    <jats:p>The study relies on secondary administrative data, subject to coding inaccuracies, and its retrospective design limits causal inferences.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>BD hospitalizations in older adults carry a high medical burden, with comorbidities impacting outcomes. Early screening, multidisciplinary care, and targeted interventions are crucial to improving management and reducing hospitalizations. Further research is needed to explore long\u2010term outcomes and outpatient care strategies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/gps.70217","type":"journal-article","created":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T08:50:01Z","timestamp":1777539001000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Bipolar Disorder Hospitalization in Older Adults: A Nationwide Retrospective Study"],"prefix":"10.1002","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-3762-9808","authenticated-orcid":false,"given":"Daniela","family":"Soberano","sequence":"first","affiliation":[{"name":"Faculty of Medicine University of Porto (FMUP)  Porto Portugal"}]},{"given":"Ana Rita","family":"Ferreira","sequence":"additional","affiliation":[{"name":"Faculty of Medicine University of Porto (FMUP)  Porto Portugal"},{"name":"RISE\u2010Health Department of Clinical Neurosciences and Mental Health Faculty of Medicine University of Porto (FMUP)  Porto Portugal"}]},{"given":"Alberto","family":"Freitas","sequence":"additional","affiliation":[{"name":"RISE\u2010Health Department of Community Medicine, Information and Health Decision Sciences (MEDCIDS) Faculty of Medicine University of Porto  Porto Portugal"}]},{"given":"Lia","family":"Fernandes","sequence":"additional","affiliation":[{"name":"RISE\u2010Health Department of Clinical Neurosciences and Mental Health Faculty of Medicine University of Porto (FMUP)  Porto Portugal"},{"name":"Psychiatry Service Unidade Local de Sa\u00fade S\u00e3o Jo\u00e3o  Porto Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6098-429X","authenticated-orcid":false,"given":"Manuel","family":"Gon\u00e7alves\u2010Pinho","sequence":"additional","affiliation":[{"name":"RISE\u2010Health Department of Community Medicine, Information and Health Decision Sciences (MEDCIDS) Faculty of Medicine University of Porto  Porto Portugal"},{"name":"Department of Psychiatry and Mental Health Unidade Local de Sa\u00fade do T\u00e2mega e Sousa  Penafiel Portugal"}]}],"member":"311","published-online":{"date-parts":[[2026,4,30]]},"reference":[{"key":"e_1_2_13_2_1","unstructured":"W. H.Organization Clinical Descriptions and Diagnostic Requirements for ICD\u201011 Mental Behavioural and Neurodevelopmental Disorders (2024)."},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.1001\/archgenpsychiatry.2011.12"},{"key":"e_1_2_13_4_1","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1016\/B978-0-12-800136-3.00012-0","volume-title":"Handbook of Mental Health and Aging","author":"Hein L.","year":"2020"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/bdi.12423"},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.psychres.2020.113255"},{"key":"e_1_2_13_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/s0165\u20100327(99)00111\u20101"},{"key":"e_1_2_13_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jagp.2013.12.176"},{"key":"e_1_2_13_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11920\u2010020\u201001216\u20106"},{"key":"e_1_2_13_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/yco.0000000000000883"},{"key":"e_1_2_13_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/s0165\u20100327(00)00180\u20104"},{"key":"e_1_2_13_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/bdi.12331"},{"key":"e_1_2_13_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2023.01.083"},{"key":"e_1_2_13_14_1","doi-asserted-by":"publisher","DOI":"10.1177\/0891988703258821"},{"key":"e_1_2_13_15_1","doi-asserted-by":"publisher","DOI":"10.3390\/medicina57060587"},{"key":"e_1_2_13_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/s0193\u2010953x(05)70397\u2010x"},{"key":"e_1_2_13_17_1","first-page":"38","volume-title":"Psychiatric Times","author":"Rej S.","year":"2014"},{"key":"e_1_2_13_18_1","doi-asserted-by":"publisher","DOI":"10.3389\/fpubh.2023.1149731"},{"key":"e_1_2_13_19_1","doi-asserted-by":"publisher","DOI":"10.2147\/ndt.s94643"},{"key":"e_1_2_13_20_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1001885"},{"key":"e_1_2_13_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2021.10.090"},{"key":"e_1_2_13_22_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00127\u2010024\u201002645\u2010x"},{"key":"e_1_2_13_23_1","unstructured":"AFHRA Quality. \u201cClinical Classifications Software (CCS) for ICD\u20109\u2010CM \u201d Healthcare Cost and Utilization Project (HCUP): [2025 25\/02\/2025] https:\/\/hcup\u2010us.ahrq.gov\/toolssoftware\/ccs\/ccs.jsp."},{"key":"e_1_2_13_24_1","doi-asserted-by":"publisher","DOI":"10.1097\/mlr.0b013e318297429c"},{"key":"e_1_2_13_25_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12877\u2010019\u20101395\u20105"},{"key":"e_1_2_13_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/0021\u20109681(87)90171\u20108"},{"key":"e_1_2_13_27_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.mlr.0000182534.19832.83"},{"key":"e_1_2_13_28_1","doi-asserted-by":"publisher","DOI":"10.1002\/eat.22955"},{"key":"e_1_2_13_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2021.10.113"},{"key":"e_1_2_13_30_1","doi-asserted-by":"publisher","DOI":"10.1001\/archpsyc.62.6.593"},{"key":"e_1_2_13_31_1","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.bp.115.180059"},{"key":"e_1_2_13_32_1","doi-asserted-by":"publisher","DOI":"10.1002\/gps.1527"},{"key":"e_1_2_13_33_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jagp.2023.10.008"},{"key":"e_1_2_13_34_1","doi-asserted-by":"publisher","DOI":"10.1192\/j.eurpsy.2023.841"},{"key":"e_1_2_13_35_1","doi-asserted-by":"publisher","DOI":"10.1177\/0891988712436683"},{"key":"e_1_2_13_36_1","doi-asserted-by":"publisher","DOI":"10.1017\/s0033291709005534"},{"key":"e_1_2_13_37_1","unstructured":"N.\u2010H. T.TrinhandB. P.Forester Bipolar Disorder in the Elderly: Differential Diagnosis and Treatment (2007)."},{"key":"e_1_2_13_38_1","doi-asserted-by":"publisher","DOI":"10.1002\/wps.20309"},{"key":"e_1_2_13_39_1","doi-asserted-by":"publisher","DOI":"10.1111\/acps.13153"},{"key":"e_1_2_13_40_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cjca.2017.10.006"},{"key":"e_1_2_13_41_1","doi-asserted-by":"publisher","DOI":"10.1080\/10673220600889256"},{"key":"e_1_2_13_42_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12991\u2010017\u20100133\u20107"},{"key":"e_1_2_13_43_1","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ps.55.9.1014"},{"key":"e_1_2_13_44_1","doi-asserted-by":"crossref","first-page":"213","DOI":"10.1007\/978-3-319-48912-4_11","volume-title":"Bipolar Disorder in Older Age Patients","author":"Depp C.","year":"2017"},{"key":"e_1_2_13_45_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2018.08.035"},{"key":"e_1_2_13_46_1","doi-asserted-by":"publisher","DOI":"10.1093\/intqhc\/mzaa093"},{"key":"e_1_2_13_47_1","doi-asserted-by":"publisher","DOI":"10.1192\/j.eurpsy.2024.1493"},{"key":"e_1_2_13_48_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11126\u2010021\u201009951\u20106"},{"key":"e_1_2_13_49_1","doi-asserted-by":"crossref","unstructured":"A.Freitas J.Gaspar andN. D.Rocha et\u00a0al. Quality in Hospital Administrative Databases (2014).","DOI":"10.12785\/amis\/081L01"},{"key":"e_1_2_13_50_1","doi-asserted-by":"publisher","DOI":"10.1016\/s0022\u20103956(03)00052\u20109"},{"key":"e_1_2_13_51_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2012.08.031"},{"key":"e_1_2_13_52_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.yebeh.2023.109447"},{"key":"e_1_2_13_53_1","doi-asserted-by":"publisher","DOI":"10.1192\/j.eurpsy.2024.1313"},{"key":"e_1_2_13_54_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12991\u2010021\u201000367\u2010x"}],"container-title":["International Journal of Geriatric Psychiatry"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/gps.70217","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/gps.70217","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/gps.70217","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T08:50:10Z","timestamp":1777539010000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/gps.70217"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,30]]},"references-count":53,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2026,5]]}},"alternative-id":["10.1002\/gps.70217"],"URL":"https:\/\/doi.org\/10.1002\/gps.70217","archive":["Portico"],"relation":{},"ISSN":["0885-6230","1099-1166"],"issn-type":[{"value":"0885-6230","type":"print"},{"value":"1099-1166","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,30]]},"assertion":[{"value":"2025-04-28","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-04-15","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-04-30","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70217"}}