HOW CAN WE IMPROVE THE PROGNOSIS OF BIPOLAR DISORDER IN LATE LIFE? Benoit H. Mulsant, MD, MS, FRCPC 1 ; Martha Sajatovic, MD 2 ; Ariel Gildengers, MD 3,4 ; Brent Forester, MD 5 1 Centre for Addiction and Mental Health & University of Toronto, Toronto, ON, Canada 2 Case Western Reserve University School of Medicine, Cleveland, OH 3 University of Pittsburgh School of Medicine, Pittsburgh, PA 4 Western Psychiatric Institute and Clinic, Pittsburgh, PA 5 McLean Hospital, Harvard Medical School, Belmont, MA Abstract: Heterogeneity of outcomes is the rule in geriatric psychiatry and late-life bipolar disorder is not an exception. While some older patients with bipolar disorder exemplify successful aging with minimal psychiatric symptoms, preserved cognition, and stable physical health, other patients experience deteriorating courses associated with cognitive and functional disability, and premature mortality due to co-morbid physical illness. In this session, the presenters will review the determinants of the outcome of bipolar disorder in late life. The first presentation will address the impact of physical health and medical comorbidities that complicate treatment and impede clinical outcomes for older people with bipolar disorder; analyses of data from treatment studies will be presented and implications for pharmacologic and psychosocial management will be discussed. The second presentation will review the mechanisms of cognitive dysfunction in late-life bipolar disorder along with the potential vulnerability and protective factors that may determine better or worse cognitive function; new data from an ongoing study examining the long term course of cognitive function in older adults with bipolar disorder will be presented. The third presentation will discuss the biomarkers have been associated with the course and outcomes of bipolar disorder, in particular biomarkers of inflammation, mitochondrial energy, oxidative stress, and neurogenesis; new data on biomarkers of oxidative stress in older adults with bipolar disorder will be presented and their potential clinical significance will be dis- cussed. The three presentations will emphasize implications for clinicians who are treating an increasing number of older adults with bipolar disorder. Taken together, they will suggest a practical approach to improve the chance that these patients experience a successful aging. Faculty Disclosures: Brent Forester, MD Research Support: NIMH - Research Grant Research Support: Family Foundation - Research Grant Ariel Gildengers, MD Nothing to disclose Benoit H. Mulsant, MD, MS, FRCPC Research Support: Pfizer - Free medication for a NIH-funded trial Research Support: Bristol-Myers Squibb - Free medication for a NIH-funded trial Shareholder: General Electric - Less than $5000 Martha Sajatovic, MD Research Support: GlaxoSmithKline Research Support: Pfizer Research Support: Merck Research Support: AstraZeneca INTEGRATED ILLNESS MANAGEMENT AND RECOVERY FOR OLDER ADULTS WITH SERIOUS MENTAL ILLNESS Kristin Davis, MA, PhD; William Reedy, MA, RN; Nancy Little, MA Thresholds-Dartmouth Research Center, Chicago, IL Abstract: Older adults are disproportionately represented in the community mental health system. Despite extensive medical needs, older adults with serious mental illnesses often do not receive treatment or, alternatively, receive inadequate treatment S20 Am J Geriatr Psychiatry 21:3, Supplement 1 2013 AAGP Annual Meeting