Objectives-Epidemiological studies suggest that elders with bipolar disorder (BD) may be at increased risk for dementia compared to the general population. We sought to investigate whether older adults with BD would present with more cognitive dysfunction than expected for their age and education, and whether they would experience a more rapid cognitive decline over three-year prospective follow-up.Methods-Thirty-three subjects age ≥ 50, mean (SD) age 69.7 (7.9) years, with BD I (n = 28) and II (n = 5) had neuropsychological examination at baseline and longitudinally over three years. All subjects were administered the Dementia Rating Scale (DRS) when euthymic. Thirty-six mentally healthy comparators ('controls'), equated on age and education, were selected from ongoing studies in our research center examining the longitudinal relationship between late-life mood disorders and cognitive function.Results-Compared to mentally healthy comparators, subjects with BD performed significantly worse on the DRS at baseline [mean (SD) 135.2 (4.7); n = 33 versus 139.5 (3.3); n = 36], and over follow-up [131.9 (7.7); n = 14 versus 139.1 (3.4); n = 22]. There was a group-by-time interaction between the subjects with BD and the controls [group × time: F(1,64) = 5.07, p = 0.028].Conclusions-In our study, older adults with BD had more cognitive dysfunction and more rapid cognitive decline than expected given their age and education. Cognitive dysfunction and accelerated cognitive decline may lead to decreased independence, with increased reliance on family and community supports, and potential placement in assisted-living facilities. NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author ManuscriptMore than 30 cross-sectional studies have revealed cognitive impairments in mixed-aged adults with bipolar disorder (BD) that are present even with symptomatic recovery (1-4). Deficits have been identified in multiple cognitive domains, including information processing speed (5,6), executive function (5-10), memory (7,(11)(12)(13)(14), attention/concentration (15,16), and visual-spatial abilities (17,18). In turn, cognitive impairment has been associated with impairment in functional abilities (5,6,13). Epidemiologic studies have suggested that BD is associated with increased risk of developing dementia (19)(20)(21).Despite the large number of cross-sectional studies, to our knowledge, there have been just six published studies on the longitudinal course of cognitive function in BD patients of any age (22-27), with only one study focused on older adults (23). This study by Dhingra and Rabins (23) used the Mini-Mental State Exam (MMSE) (28) to follow older patients for 5-7 years after they were hospitalized for mania. The investigators found that 8 (32%) of the 25 BD subjects followed-up experienced a decline in their MMSE to a score below 24 (indicating significant cognitive impairment), including 5 subjects (20%) who became so cognitively impaired that they required nursing home placement. Although no control group wa...
Hearing aids are associated with better QoL than having HL and going without aids. Clinical psychologists can improve coping among those with HL and motivate hearing aid use.
Adults with hearing loss living in rural areas had poor perceived tangible support. The provision of support to address a hearing loss could be worse for these adults compared to adults who lived in urban settings.
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