Objective
Cognitive dysfunction is a core feature of Bipolar Disorder (BD) in both adult and geriatric patients. However, little is known about whether cognitive functioning declines at a faster rate in patients with BD and there are conflicting reports regarding the relationship between age and cognitive functioning in this population. This cross-sectional study examined the relationship between age and cognitive functioning in patients with BD.
Methods
Patients with BD I (n=113) and healthy adults (n=64) ages 18–87 completed measures of processing speed, attention, executive functioning, verbal fluency, and clinical symptomatology. Groupwise comparisons were used to examine differences between patients and the comparison group and adult and geriatric BD cohorts. A series of linear regressions was conducted to examine the relationship of age and cognitive functioning, and clinical variables and cognition.
Results
Patients performed significantly worse than the comparison group on all neuropsychological measures. Age was a significant predictor of Trails A scores with older age associated with worse performance.
Conclusions
Older age was associated with poorer performance on Trails A in patients with BD but not healthy adults. These results are suggestive of greater dysfunction in processing speed with older age in patients with BD compared to a healthy comparison group. As cognitive functioning is associated with community outcomes, these findings suggest a need for treatments targeting cognitive symptoms across the lifespan. Future research exploring neurobiological evidence for neurodegenerative processes in bipolar disorder will pave the way for potential therapeutic interventions.
Objectives
We explored relationships between general religiousness, positive religious coping, negative religious coping (spiritual struggle), and affective symptoms among geriatric mood disordered outpatients, in the northeastern United States.
Methods
We assessed for general religiousness (religious affiliation, belief in God, private and public religious activity) and positive/negative religious coping, alongside interview and self-report measures of affective functioning in a diagnostically heterogeneous sample of n = 34 geriatric mood disordered outpatients (n = 16 Bipolar, n = 18 Major Depressive) at a psychiatric hospital in eastern Massachusetts.
Results
Except for a modest correlation between private prayer and lower Geriatric Depression Scale (GDS) scores, general religious factors (belief in God, public religious activity and religious affiliation) as well as positive religious coping were unrelated to affective symptoms after correcting for multiple comparisons and controlling for significant covariates. However a large effect of spiritual struggle was observed on greater symptom levels (up to 19.4% shared variance). Further, mean levels of spiritual struggle and its observed effects on symptoms were equivalent irrespective of religious affiliation, belief, private and public religious activity.
Conclusions
Previously observed effects of general religiousness on (less) depression among geriatric mood disordered patients may be less pronounced in less religious areas of the United States. However, spiritual struggle appears to be a common and important risk factor for depressive symptoms, regardless of patients' general level of religiousness. Further research on spiritual struggle is warranted among geriatric mood disordered patients.
Study results suggest consensus among regarding psychosocial treatments. Limited acceptance amongst US psychologists about the suitability of pharmacotherapy for late-life PDs contrasted with the views expressed by experts surveyed in Netherlands and Belgium studies.
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