{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T03:52:40Z","timestamp":1777521160273,"version":"3.51.4"},"reference-count":55,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2023,10,5]],"date-time":"2023-10-05T00:00:00Z","timestamp":1696464000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100012729","name":"Clinical and Translational Science Collaborative of Cleveland, School of Medicine, Case Western Reserve University","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100012729","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100013893","name":"International Society for Bipolar Disorders","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100013893","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100006108","name":"National Center for Advancing Translational Sciences","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100006108","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Bipolar Disorders"],"published-print":{"date-parts":[[2023,12]]},"abstract":"Abstract<\/jats:title>Objective<\/jats:title>The current literature on employment in older adults with bipolar disorder (OABD) is limited. Using the Global Aging and Geriatric Experiments in Bipolar Disorder Database (GAGE\u2010BD), we examined the relationship of occupational status in OABD to other demographic and clinical characteristics.<\/jats:p><\/jats:sec>Methods<\/jats:title>Seven hundred and thirty\u2010eight participants from 11 international samples with data on educational level and occupational status were included. Employment status was dichotomized as employed versus unemployed. Generalized linear mixed models with random intercepts for the study cohort were used to examine the relationship between baseline characteristics and employment. Predictors in the models included baseline demographics, education, psychiatric symptom severity, psychiatric comorbidity, somatic comorbidity, and prior psychiatric hospitalizations.<\/jats:p><\/jats:sec>Results<\/jats:title>In the sample, 23.6% (n<\/jats:italic>\u2009=\u2009174) were employed, while 76.4% were unemployed (n<\/jats:italic>\u2009=\u2009564). In multivariable logistic regression models, less education, older age, a history of both anxiety and substance\/alcohol use disorders, more prior psychiatric hospitalizations, and higher levels of BD depression severity were associated with greater odds of unemployment. In the subsample of individuals less than 65\u2009years of age, findings were similar. No significant association between manic symptoms, gender, age of onset, or employment status was observed.<\/jats:p><\/jats:sec>Conclusion<\/jats:title>Results suggest an association between educational level, age, psychiatric severity and comorbidity in relation to employment in OABD. Implications include the need for management of psychiatric symptoms and comorbidity across the lifespan, as well as improving educational access for people with BD and skills training or other support for those with work\u2010life breaks to re\u2010enter employment and optimize the overall outcome.<\/jats:p><\/jats:sec>","DOI":"10.1111\/bdi.13381","type":"journal-article","created":{"date-parts":[[2023,10,6]],"date-time":"2023-10-06T17:30:13Z","timestamp":1696613413000},"page":"637-647","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Demographic and clinical associations to employment status in older\u2010age bipolar disorder: Analysis from the GAGE\u2010BD<\/scp> database project"],"prefix":"10.1111","volume":"25","author":[{"given":"Amulya","family":"Mallu","sequence":"first","affiliation":[{"name":"Case Western Reserve University School of Medicine Cleveland Ohio 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