Cognition in older age bipolar disorder: An analysis of archival data across the globe.
Journal: Journal of affective disorders
Volume: 355
Issue:
Year of Publication:
Affiliated Institutions:
Department of Psychiatry, University of California San Diego, San Diego, CA, USA; Desert-Pacific Mental Illness Research Education and Clinical Center, VA San Diego Healthcare System, San Diego, CA, USA. Electronic address: fklaus@ucsd.edu.
Department of Psychiatry, University of California San Diego, San Diego, CA, USA.
Departamento de Psiquiatria, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.
GGZ inGeest Specialized Mental Health Care, Department of Old Age Psychiatry, Amsterdam, the Netherlands; Amsterdam UMC, Amsterdam Public Health research institute, Amsterdam, the Netherlands.
Department of Public Health Sciences, Miller School of Medicine, University of Miami, Miami, FL, USA.
Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
Amsterdam UMC, Amsterdam Neuroscience, Mood, Anxiety, Psychosis, Sleep & Stress Program, Amsterdam, the Netherlands; Department of Psychiatry, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht, the Netherlands.
Laboratory of Neuroscience (LIM-), Department and Institute of Psychiatry, HCFMUSP, Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil.
Department of Psychiatry, University of Pittsburgh School of Medicine, Western Psychiatric Hospital, USA.
Institute of Behavioral Science, The Feinstein Institutes of Medical Research, New York, USA.
Department of Psychiatry, Center for Addiction & Mental Health, University of Toronto, Toronto, Canada.
Institute of Clinical Psychology, Leiden University, Leiden, the Netherlands.
Department of Psychiatry, Jewish General Hospital/Lady Davis Institute, McGill University, Montreal, Canada.
Case Western Reserve University School of Medicine (MS), University Hospitals Cleveland Medical Center, Cleveland, OH, USA.
GZZ inGeest Specialized Mental Health Care, Department of Old Age Psychiatry, Amsterdam, the Netherlands.
Department of Psychiatry, University of California San Diego, San Diego, CA, USA; Desert-Pacific Mental Illness Research Education and Clinical Center, VA San Diego Healthcare System, San Diego, CA, USA.
Department of Psychiatry and Behavioral Sciences, University of Texas/McGovern Medical School, Houston, TX, USA; Faculdade Santa Casa BH, Belo Horizonte, Minas Gerais, Brazil.
Abstract summary
Cognitive deficits in bipolar disorder (BD) impact functioning and are main contributors to disability in older age BD (OABD). We investigated the difference between OABD and age-comparable healthy comparison (HC) participants and, among those with BD, the associations between age, global cognitive performance, symptom severity and functioning using a large, cross-sectional, archival dataset harmonized from 7 international OABD studies.Data from the Global Aging and Geriatric Experiments in Bipolar Disorder (GAGE-BD) database, spanning various standardized measures of cognition, functioning and clinical characteristics, were analyzed. The sample included 662 euthymic to mildly symptomatic participants aged minimum 50years (509 BD, 153 HC), able to undergo extensive cognitive testing. Linear mixed models estimated associations between diagnosis and global cognitive performance (g-score, harmonized across studies), and within OABD between g-score and severity of mania and depressive symptoms, duration of illness and lithium use and of global functioning.After adjustment for study cohort, age, gender and employment status, there was no significant difference in g-score between OABD and HC, while a significant interaction emerged between employment status and diagnostic group (better global cognition associated with working) in BD. Within OABD, better g-scores were associated with fewer manic symptoms, higher education and better functioning.Cross-sectional design and loss of granularity due to harmonization.More research is needed to understand heterogenous longitudinal patterns of cognitive change in BD and understand whether particular cognitive domains might be affected in OABD in order to develop new therapeutic efforts for cognitive dysfunction OABD.
Authors & Co-authors:
Klaus
Ng
Barbosa
Beunders
Briggs
Burdick
Dols
Forlenza
Gildengers
Millett
Mulsant
Orhan
Rajji
Rej
Sajatovic
Sarna
Schouws
Sutherland
Teixeira
Yala
Eyler
Study Outcome
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