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Age-related changes in physiology in individuals with bipolar disorder

Research output: Contribution to journalArticlepeer-review

Original languageEnglish
Pages (from-to)157-168
Number of pages12
JournalJournal of affective disorders
Volume296
DOIs
Published1 Jan 2022

Bibliographical note

Funding Information: JM acknowledges studentship funding from the Biotechnology and Biological Sciences Research Council (BBSRC) (ref: 2050702) and Eli Lilly and Company Limited . AHY and CML are part-funded by the National Institute for Health Research (NIHR) Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London . The views expressed are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health and Social Care. AHY is employed by King's College London, is an honorary consultant at SLaM (NHS UK) and a deputy editor of BJPsych Open. He has given paid lectures and served on advisory boards for the following companies with drugs used in affective and related disorders: AstraZenaca, Eli Lilly, Lundbeck, Sunovion, Servier, Livanova, Janssen, Allegan, Bionomics, Sumitomo Dainippon Pharma and COMPASS. He is a consultant to Johnson & Johnson and to Livanova. He has received honoraria for attending advisory boards and presenting talks at meetings organised by LivaNova. He is Principal Investigator in the Restore-Life VNS registry study funded by LivaNova, Principal Investigator on ESKETINTRD3004: “An Open-label, Long-term, Safety and Efficacy Study of Intranasal Esketamine in Treatment-resistant Depression”, Principal Investigator on “The Effects of Psilocybin on Cognitive Function in Healthy Participants”, Principal Investigator on “The Safety and Efficacy of Psilocybin in Participants with Treatment-Resistant Depression (P-TRD)”, UK Chief Investigator for Novartis MDD study MIJ821A12201 and has received grant funding (past and present) from: NIMH (USA); CIHR (Canada); NARSAD (USA); Stanley Medical Research Institute (USA); MRC (UK); Wellcome Trust (UK); Royal College of Physicians (Edin); BMA (UK); UBC-VGH Foundation (Canada); WEDC (Canada); CCS Depression Research Fund (Canada); MSFHR (Canada); NIHR (UK); Janssen (UK). He has no shareholdings in pharmaceutical companies. CML is a member of the Scientific Advisory Board of Myriad Neuroscience. Funding Information: This research has been conducted using data from UK Biobank, a major biomedical database. This project made use of time on Rosalind HPC, funded by Guy's & St Thomas’ Hospital NHS Trust Biomedical Research Centre (GSTT-BRC), South London & Maudsley NHS Trust Biomedical Research Centre (SLAM-BRC), and Faculty of Natural Mathematics & Science (NMS) at King's College London . Funding Information: JM acknowledges studentship funding from the Biotechnology and Biological Sciences Research Council (BBSRC) (ref: 2050702) and Eli Lilly and Company Limited. AHY and CML are part-funded by the National Institute for Health Research (NIHR) Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London. The views expressed are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health and Social Care. AHY is employed by King's College London, is an honorary consultant at SLaM (NHS UK) and a deputy editor of BJPsych Open. He has given paid lectures and served on advisory boards for the following companies with drugs used in affective and related disorders: AstraZenaca, Eli Lilly, Lundbeck, Sunovion, Servier, Livanova, Janssen, Allegan, Bionomics, Sumitomo Dainippon Pharma and COMPASS. He is a consultant to Johnson & Johnson and to Livanova. He has received honoraria for attending advisory boards and presenting talks at meetings organised by LivaNova. He is Principal Investigator in the Restore-Life VNS registry study funded by LivaNova, Principal Investigator on ESKETINTRD3004: ?An Open-label, Long-term, Safety and Efficacy Study of Intranasal Esketamine in Treatment-resistant Depression?, Principal Investigator on ?The Effects of Psilocybin on Cognitive Function in Healthy Participants?, Principal Investigator on ?The Safety and Efficacy of Psilocybin in Participants with Treatment-Resistant Depression (P-TRD)?, UK Chief Investigator for Novartis MDD study MIJ821A12201 and has received grant funding (past and present) from: NIMH (USA); CIHR (Canada); NARSAD (USA); Stanley Medical Research Institute (USA); MRC (UK); Wellcome Trust (UK); Royal College of Physicians (Edin); BMA (UK); UBC-VGH Foundation (Canada); WEDC (Canada); CCS Depression Research Fund (Canada); MSFHR (Canada); NIHR (UK); Janssen (UK). He has no shareholdings in pharmaceutical companies. CML is a member of the Scientific Advisory Board of Myriad Neuroscience.This research has been conducted using data from UK Biobank, a major biomedical database. This project made use of time on Rosalind HPC, funded by Guy's & St Thomas? Hospital NHS Trust Biomedical Research Centre (GSTT-BRC), South London & Maudsley NHS Trust Biomedical Research Centre (SLAM-BRC), and Faculty of Natural Mathematics & Science (NMS) at King's College London. Publisher Copyright: © 2021

King's Authors

Abstract

Background: Individuals with bipolar disorder have a reduced life expectancy and may experience accelerated biological ageing. In individuals with bipolar disorder and healthy controls, we examined differences in age-related changes in physiology. Methods: UK Biobank recruited more than 500,000 participants, aged 37–73, between 2006 and 2010. Generalised additive models were used to examine associations between age and grip strength, cardiovascular function, body composition, lung function and heel bone mineral density. Results: The main dataset included 271,118 adults (mean age = 56.04 years; 49.60% females). We found statistically significant differences between cases and controls for grip strength, blood pressure, pulse rate and body composition, with standardised mean differences of up to -0.24 (95% CI -0.28 to -0.19). Evidence of differences in lung function, heel bone mineral density or arterial stiffness was limited. Case-control differences were most evident for age-related changes in cardiovascular function (both sexes) and body composition (females). Differences did not uniformly narrow or widen with age and differed by sex. For example, the difference in systolic blood pressure between male cases and controls was -1.3 mmHg at age 50 and widened to -4.7 mmHg at age 65. Diastolic blood pressure in female cases was 1.2 mmHg higher at age 40 and -1.2 mmHg lower at age 65. Limitations: Analyses did not distinguish between bipolar disorder subtypes. Results may not generalise to other age groups. Conclusions: Differences between bipolar disorder cases and controls were most evident for cardiovascular and body composition measures. Targeted screening for cardiovascular and metabolic health in middle age is warranted to potentially mitigate excess mortality.

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