When SFU associate gerontology professor Norman O’Rourke and his students searched the bipolar disorder (BD) literature, they found only two references to older adults with BD. “So we know very little about caring for older adults with bipolar disorder,” says O’Rourke, who heads a four-year multidisciplinary national study on the subject, funded by a $722,000 Canadian Institutes of Health Research grant.
Characterized by major depressive and manic (or mixed-manic) episodes, BD affects around half a million people in Canada. Roughly 75,000 Canadians over 50 years of age have BD and according to O’Rourke this number will triple over the next decade as people with BD are living longer. Older adults with BD also have to deal with all the other issues that come with aging. “We are dealing with older adults with BD now, perhaps for the first time in history,” explains O’Rourke, pointing out that in the 1950s treatments such as lithium became available, and today’s drugs are even more effective. Although BD is primarily treated with drugs, therapy and social support, up to 80% of people with BD also self- medicate and the risk of suicide is high.
O’Rourke wants to help, using the Global Positioning System (GPS) capabilities of smartphones and tablets to find out how geo- spatial patterns of movement correlate with BD symptoms. His Bipolar Affective Disorder and Older Adults study distributes iPad Minis to people aged 50+ with BD. “The idea is to link mood-in-the-moment to geographic patterns,” says O’Rourke. The researchers will track place (e.g., River Rock Casino) and location (i.e., latitude and longitude) from the participants’ iPads and record their mood through a questionnaire that appears on the device.
The participants can set customized warning messages to alert them, their case managers and families to BD symptoms. “Our goal with this research is to create self-care or care- management tools that help older BD adults live safely and independently,” says O’Rourke.
As people with chronic depression are at higher risk of getting Alzheimer’s disease, the project will also study how BD symptoms may be related to the onset of dementia. In the future, O’Rourke would like to extend the study to people with BD under 50 and look at the friends and family of people with BD, often called the “silent sufferers.”
“We want SFU to become a knowledge centre for BD research in Canada,” says O’Rourke.
As a co-author of three statistics textbooks, O’Rourke was drawn to bipolar disorder research as a statistical challenge. BD symptoms are variable and complex. “Fortunately, contemporary statistical methods allow us to examine factors such as the frequency, duration and severity of mood episodes—depression and mania—over time,” says O’Rourke. The speed of mood change in BD is known as cycling, as the person oscillates from one pole to the other, and it’s a key clinical indicator.
O’Rourke’s current study is truly multidisciplinary, involving mathematician Peter Borwein and computer scientists Ted Kirkpatrick and Uwe Glässer from SFU’s Interdisciplinary Research in the Mathematical and Computational Sciences (IRMACS) Centre, Wendy Thornton in psychology, and Atiya Mahmood and Andrew Sixsmith in gerontology at SFU. Other collaborators include researchers from six universities in Canada, USA, and Australia in fields of biomedical engineering, social work, mathematics, architecture, clinical neuropsychiatry, and human geography.
O’Rourke is a clinical geropsychologist. He completed his doctorate at the University of Ottawa and his residency in Rush-Presbyterian-St. Luke’s hospital in Chicago. His team will soon begin recruiting participants at UBC Vancouver, UBC Okanagan, University of Calgary, and the Rotman Research Institute in Toronto.