Elderly persons presenting with manic episodes are heterogeneous,<sup>96 Young R.C., Klerman G. Mania in late life: Focus on age at onset Am J Psychiatry 1992 ;  149 : 867-876

Cliccare qui per andare alla sezione Riferimenti</sup> at minimum representing two groups: (1) patients experiencing a late-life manic episode of a bipolar disorder with an age at onset in young adult life and (2) patients with no episodes of mania prior to late life. Within this latter group would be patients with no young adult history of mood disorder as well as those with an earlier onset mood disorder, but only with a history of major depressive episodes, never mania. This review is organized around two questions related to this heterogeneity: (1) Is mania modified by age such that manic episodes of young adult-onset bipolar disorder present differently in late life? (2) Do patients with first onset of mania in late life represent a distinct subgroup? The etiologic and pathophysiologic implications of these questions are considered. Pharmacotherapeutic management is discussed briefly from these perspectives.