ETD

• aging
• bipolar disorder
• FAST-O
• functional assessment
• late-life mental health.
• older adults
• older age
• psychosocial functioning

Background: Bipolar disorder (BD) is increasingly recognized in later life, referred to as Older Age Bipolar Disorder (OABD) or Late-Life Bipolar Disorder (LLBD). This subgroup faces distinctive challenges, including greater cognitive impairment, high rates of medical comorbidities, and reduced psychosocial functioning.
Objective: To translate and validate the Italian version of the Functioning Assessment Short Test for Older adults (FAST-O), addressing the lack of functioning measures for OABD in Italy.
Methods: We enrolled 131 patients with BD (mean age = 65.1 ± 11.6 years; 40.5% male). Clinical assessment included HAM-D, YMRS, MMSE, GAF, and SOFAS. The FAST-O was administered. Internal consistency (Cronbach’s α), factorial validity (CFA with DWLS), and concurrent validity (Spearman’s correlations) were examined. Discriminant validity was tested by comparing euthymic vs. symptomatic patients.
Results: Internal consistency was excellent (α = 0.97 total; subscales 0.84–0.95). CFA supported the six-factor structure (CFI = 0.999, TLI = 0.999, RMSEA = 0.061, SRMR = 0.063), though items 8 and 21 showed weaker loadings (0.625, 0.452). The FAST-O correlated strongly with GAF (ρ = −0.94) and SOFAS (ρ = −0.92), and moderately with HAM-D, YMRS, and MMSE. Symptomatic patients scored higher than euthymic ones (median 48 vs. 12.5; Cohen’s d = 2.68).
Conclusions: The Italian FAST-O is a reliable, age-appropriate tool for assessing psychosocial functioning in OABD, supporting accurate evaluation and tailored interventions.