Researchers do not yet understand the exact nature of the relationship between bipolar disorder and dementia. However, the two conditions share several features. Recent research suggests both are associated with progressive cognitive decline.

Bipolar disorder (BD) is a mood disorder. BD causes shifts in a person’s mood, energy, and behavior.

Dementia is an umbrella term describing various symptoms of cognitive decline. These are shared by a number of conditions associated with aging, such as Alzheimer’s disease.

Due to their shared features, some people with either late-onset BD or frontotemporal dementia symptoms will receive a diagnosis for the other condition.

This article explores the connection between BD and dementia. It looks at their similarities and differences and how to tell the difference between the two conditions.

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The relationship between BD and dementia is complex. Research suggests that having either condition may place a person at higher risk of developing the other condition. However, more research is needed to determine the exact connection.

A 2018 meta-analysis found a significant association between a history of BD and an increased risk of dementia in older adults.

According to the authors, the literature reviewed robustly proves that mood disorders in general are associated with higher risks of dementia. Furthermore, for a certain sub-group of individuals, BD can be characterized as a progressive condition leading to cognitive impairment and dementia.

Historically, scientists have understood BD as a cyclic disease, with people recovering fully between mood episodes. However, according to a 2016 study, significant evidence has accumulated over the last decade supporting BD’s progressive features.

A 2020 meta-analysis concluded that those with BD are around three times more likely to develop dementia.

Read about bipolar disorder.

Late-onset BD and dementia share several features, which can make diagnosis difficult. Because of this, it is common for a considerable proportion of people with dementia to first receive a BD diagnosis.


Similarities include:

  • disinhibition
  • cognitive alterations
  • depressive symptoms, including:
    • apathy
    • anhedonia
    • lack of motivation
    • lack of interest
    • lack of energy
    • impaired concentration
  • manic symptoms, such as:
    • irritability
    • pressured speech
    • impulsivity
    • psychomotor agitation
    • excessive jocularity or cheerfulness
    • inappropriate social conduct or sexual behavior


While they share many overlapping symptoms, BD and dementia also have some key differences.


Depressive symptoms of BD that are not common with dementia include:

  • guilty ruminations
  • feeling of worthlessness
  • suicidal thoughts

Suicide prevention

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  • Ask the tough question: “Are you considering suicide?”
  • Listen to the person without judgment.
  • Call 911 or the local emergency number, or text TALK to 741741 to communicate with a trained crisis counselor.
  • Stay with the person until professional help arrives.
  • Try to remove any weapons, medications, or other potentially harmful objects if it’s safe to do so.

If you or someone you know is having thoughts of suicide, a prevention hotline can help. The 988 Suicide and Crisis Lifeline is available 24 hours a day at 988. During a crisis, people who are hard of hearing can use their preferred relay service or dial 711 then 988.

Find more links and local resources.

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Those living with dementia may act apathetic and emotionally withdrawn. However, they often lack the sadness that characterizes BD depression.

Manic symptoms of BD that are not typical with dementia include:

  • a sense of grandiosity and invulnerability
  • increased energy
  • decreased need for sleep
  • elevated mood with inflated self-esteem


Symptoms of dementia not typical of BD include:

  • repetitive motor behavior
  • apparent loss of knowledge of social norms
  • lack of interest in sex

BD and dementia have a high number of shared features and subtle distinctions between their presentation of symptoms. As a result, it is essential to contact a healthcare professional if someone suspects they or a loved one may be living with BD or dementia.

A healthcare professional can speak with a person about their medical history and symptoms. They can also perform specific cognition and dementia tests to assess whether a person may have dementia.

The following are answers to some questions people frequently ask about BD and dementia.

Is memory loss common in bipolar disorder?

Yes. Cognitive impairment is a common feature of BD, including memory loss.

What does bipolar look like in the elderly?

Late-onset BD has a couple of key differences from early-onset BD, according to older research from 2011. Episodes may be more frequent and more persistently depressive, rather than manic. Older adults tend to have symptoms that score lower on the Manic State Rating Scale, including:

  • activity‐energy score
  • sexual interest
  • religiosity
  • initiating and creating plans

Does bipolar get worse with age?

Potentially, yes. BD can present differently in older adults. This can include more frequent episodes, less severe manic symptoms, and more severe depressive symptoms.

Bipolar disorder resources

Visit our dedicated hub for more research-backed information and in-depth resources on bipolar disorder.

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BD and dementia share several features, which can make diagnosis difficult. People with BD may receive an initial diagnosis of frontotemporal dementia. Conversely, sometimes, people with frontotemporal dementia may initially receive a diagnosis of BD.

Researchers do not yet fully understand the connection between the two conditions. However, a growing body of research suggests that BD may be a progressive condition associated with worsening cognitive decline over time.