Bipolar disorder in elderly patients may present as an evolution of the disease initiated in younger stages or as an entity newly emerging. In addition, mania in the elderly, has characteristics that make it different from the adult. These disorders can be correlated with underlying vascular or degenerative disorders [1].

Review of the relevant literature by searching PUBMED, limited to studies of greater scientific hierarchy.

The existence of changes in the manic phase motivated by the influence of vascular disease, as well as the importance of the changes experienced in therapy at the rate of underlying organic disease described. The useful pharmacotherapeutic approach in this case is discussed.

The most recent research points in the direction of a more organic for mania late age-related substrate. The diverse etiology requires differential diagnosis for addressing the underlying causes [1]. The clinic does not dim with age, but increases the tendency to develop rapid cycling as age progresses. It is also more frequent occurrence of paranoid and aggressive traits, especially in situations of confrontation, along with increased dysphoria [2]. The therapeutic management by neuroleptics require very careful attention, because of the vulnerability of this group to develop adverse effects. Mood stabilizers use has been demonstrated as effective as in young [2].

The authors have not supplied their declaration of competing interest.