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This first\u2010ever analysis of the Global Aging &amp; Geriatric Experiments in Bipolar Disorder Database (GAGE\u2010BD) investigated associations among age, BD symptoms, comorbidity, and functioning.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This analysis used harmonized, baseline, cross\u2010sectional data from 19 international studies (N\u00a0=\u00a01377). Standardized measures included the Young Mania Rating Scale (YMRS), Hamilton Depression Rating Scale (HAM\u2010D), Montgomery\u2010Asberg Depression Rating Scale (MADRS), and Global Assessment of Functioning (GAF).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Mean sample age was 60.8\u00a0years (standard deviation [SD] 12.2\u00a0years), 55% female, 72% BD I. Mood symptom severity was low: mean total YMRS score of 4.3 (SD 5.4) and moderate\u2010to\u2010severe depression in only 22%. Controlled for sample effects, both manic and depressive symptom severity appeared lower among older individuals (\n                      <jats:italic>p<\/jats:italic>\n                      's\u00a0&lt;\u00a00.0001). The negative relationship between older age and symptom severity was similar across sexes, but was stronger among those with lower education levels. GAF was mildly impaired (mean\u00a0=62.0, SD\u00a0=\u00a013.3) and somatic burden was high (mean\u00a0=2.42, SD\u00a0=\u00a01.97). Comorbidity burden was not associated with GAF. However, higher depressive (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.0001) and manic (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.0001) symptoms were associated with lower GAF, most strongly among older individuals.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Findings suggest an attenuation of BD symptoms in OABD, despite extensive somatic burden. Depressive symptom severity was strongly associated with worse functioning in older individuals, underscoring the need for effective treatments of BD depression in older people. This international collaboration lays a path for the development of a better understanding of aging in BD.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/bdi.13119","type":"journal-article","created":{"date-parts":[[2021,7,27]],"date-time":"2021-07-27T12:44:45Z","timestamp":1627389885000},"page":"195-206","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":48,"title":["Bipolar symptoms, somatic burden, and functioning in older\u2010age bipolar disorder: Analyses from the Global Aging &amp; Geriatric Experiments in Bipolar Disorder Database project"],"prefix":"10.1111","volume":"24","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3073-668X","authenticated-orcid":false,"given":"Martha","family":"Sajatovic","sequence":"first","affiliation":[{"name":"Case Western Reserve University School of Medicine University Hospitals Cleveland Medical Center  Cleveland OH USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1964-0318","authenticated-orcid":false,"given":"Annemiek","family":"Dols","sequence":"additional","affiliation":[{"name":"GGZ inGeest Amsterdam UMC VU Medical Center Amsterdam Neuroscience Amsterdam Public Health Research Institute  Amsterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3908-9124","authenticated-orcid":false,"given":"Soham","family":"Rej","sequence":"additional","affiliation":[{"name":"Lady Davis Institute McGill University  Montreal Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8689-6199","authenticated-orcid":false,"given":"Osvaldo P.","family":"Almeida","sequence":"additional","affiliation":[{"name":"University of Western Australia  Perth Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9620-2579","authenticated-orcid":false,"given":"Alexandra J.M.","family":"Beunders","sequence":"additional","affiliation":[{"name":"GGZ inGeest Amsterdam UMC VU Medical Center Amsterdam Neuroscience Amsterdam Public Health Research Institute  Amsterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6363-4698","authenticated-orcid":false,"given":"Hilary P.","family":"Blumberg","sequence":"additional","affiliation":[{"name":"Department of Psychiatry Yale School of Medicine  New Haven CT USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Farren B. 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