Demographic and Clinical Associations to Employment Status in older-Age Bipolar Disorder: Analysis from the GAGE-BD Database Project

Authors

Amulya Mallu, Case Western Reserve UniversityFollow
Carol K. Chan, Case Western Reserve UniversityFollow
Kaylee Sarna, Case Western Reserve University
Joy Yala, Case Western Reserve UniversityFollow
Farren B.S. Briggs, Case Western Reserve UniversityFollow
Martha Sajatovic, Case Western Reserve UniversityFollow

Author ORCID Identifier

Martha Sajatovic

Document Type

Article

Publication Date

12-1-2023

Abstract

Objective: 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-BD), we examined the relationship of occupational status in OABD to other demographic and clinical characteristics. Methods: Seven hundred and thirty-eight 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. Results: In the sample, 23.6% (n = 174) were employed, while 76.4% were unemployed (n = 564). 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 years of age, findings were similar. No significant association between manic symptoms, gender, age of onset, or employment status was observed. Conclusion: 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-life breaks to re-enter employment and optimize the overall outcome.

Keywords

aging, bipolar disorder, employment, functioning, somatic burden

Language

English

Publication Title

Bipolar Disorders

Grant

UL1TR002548

Rights

© The Author(s) 2023. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/BY-NC-ND/4.0/), which permits non-commercial copying and redistribution of the material in any medium or format, provided the original work is not changed in any way and is properly cited.

Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial-No Derivative Works 4.0 International License.

Recommended Citation

Mallu A, Chan CK, Eyler LT, Dols A, Rej S, Blumberg HP, Sarna K, Forester BP, Patrick RE, Forlenza OV, Jimenez E, Vieta E, Schouws S, Sutherland A, Yala J, Briggs FBS, Sajatovic M. Demographic and clinical associations to employment status in older-age bipolar disorder: Analysis from the GAGE-BD database project. Bipolar Disord. 2023 Dec;25(8):637-647. doi: 10.1111/bdi.13381. Epub 2023 Oct 5. PMID: 37798096; PMCID: PMC10843228.