Five‐year follow‐up of cognitive impairment in older adults with bipolar disorder

Schouws, Sigfried; Comijs, Hannie C.; Dols, Annemiek; Beekman, Aartjan T.F.; Stek, Max L.

doi:10.1111/bdi.12374

Cited by 65 publications

(53 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…A total of four studies were included evaluating longitudinal neuropsychological functioning in late‐life BD . All four studies provided data that allowed a comparison between patients and controls.…”

Section: Resultsmentioning

confidence: 99%

“…16 Conversely, most longitudinal studies have reported stability in neurocognitive deficits during a follow-up period that ranged between 1 and 5 years. [20][21][22] In fact, two meta-analyses conducted on this subject have reported stability in neurocognitive performance among middle-life BD subjects. 23,24 Nonetheless, it remains plausible that deterioration in neurocognitive performance might occur in very early or late stages of the course of this disease, and meta-analyses conducted on middle-life patients (or averaging over patients across all stages) were unable to detect these processes.…”

Section: Szmulewicz Et Almentioning

confidence: 87%

“…23,24 Nonetheless, it remains plausible that deterioration in neurocognitive performance might occur in very early or late stages of the course of this disease, and meta-analyses conducted on middle-life patients (or averaging over patients across all stages) were unable to detect these processes. Recently, a number of longitudinal studies conducted on recent-onset BD [25][26][27] and late-life BD 22,28 have been published. Most of these studies concur in reporting stability in longitudinal neurocognitive performance among BD patients during the follow-up period.…”

Section: Szmulewicz Et Almentioning

confidence: 99%

“…For example, Kapczinski's staging model suggests a progression from no cognitive impairments in the premorbid and early stages of the illness—in which periods of euthymia are well‐defined—to severe cognitive impairments in later stages of the disorder . Conversely, most longitudinal studies have reported stability in neurocognitive deficits during a follow‐up period that ranged between 1 and 5 years . In fact, two meta‐analyses conducted on this subject have reported stability in neurocognitive performance among middle‐life BD subjects .…”

Section: Introductionmentioning

confidence: 96%

See 3 more Smart Citations

Longitudinal analysis of cognitive performances in recent‐onset and late‐life Bipolar Disorder: A systematic review and meta‐analysis

2019

View full text Add to dashboard Cite

Objectives Neurocognitive deficits have been widely reported in euthymic Bipolar Disorder (BD) patients and contribute to functional disability. However, the longitudinal trajectory of these deficits remains a subject of debate. Although most research to this date shows that neurocognitive deficits tend to be stable among middle‐age BD patients, it remains plausible that deterioration occurs at either early or late stages of this condition. Methods We conducted a comprehensive meta‐analysis of studies that reported longitudinal neurocognitive performance among individuals with BD either within the year of their diagnosis or among late‐life BD patients. Pooled effects of standardized mean differences (SMDs) for changes in neuropsychological scores over follow‐up were estimated using random effects model. We also examined effect moderators, such as length of follow‐up, mood state, or pharmacological load. Results Eight studies met inclusion criteria for recent‐onset and four studies for late‐life BD analysis. No evidence for a deterioration in neurocognitive functioning was observed among recent‐onset BD patients (8 studies, 284 patients, SMD: 0.12, 95% CI −0.06 to 0.30, mean follow‐up: 17 months) nor for late‐life BD patients (4 studies, 153 patients, SMD: −0.35, 95% CI −0.84 to 0.15, mean follow‐up: 33 months). None of the moderators were shown to be significant. Conclusions These results, when appraised together with the findings in middle‐life BD patients and individuals at genetic risk for BD, suggest that neurodevelopmental factors might play a significant role in cognitive deficits in BD and do not support the notion of progressive cognitive decline in most patients with BD.

show abstract

Section: Resultsmentioning

confidence: 99%

Section: Szmulewicz Et Almentioning

confidence: 87%

Section: Szmulewicz Et Almentioning

confidence: 99%

Section: Introductionmentioning

confidence: 96%

See 2 more Smart Citations

Longitudinal analysis of cognitive performances in recent‐onset and late‐life Bipolar Disorder: A systematic review and meta‐analysis

2019

View full text Add to dashboard Cite

show abstract

“…This cognitive dysfunction is relatively stable, related to the number of mood episodes earlier in life, and does not appear to exceed normal aging in 2‐5‐year follow‐up 634, 635, 636. Lithium use has been associated with lower rates of cognitive disorders in BD,637 and higher lithium levels in drinking water may be associated with lower dementia risks,638, 639 although prospective trials are required to definitively assess this.…”

Section: Specific Populationsmentioning

confidence: 98%

Canadian Network for Mood and Anxiety Treatments (CANMAT) and International Society for Bipolar Disorders (ISBD) 2018 guidelines for the management of patients with bipolar disorder

et al. 2018

View full text Add to dashboard Cite

The Canadian Network for Mood and Anxiety Treatments (CANMAT) previously published treatment guidelines for bipolar disorder in 2005, along with international commentaries and subsequent updates in 2007, 2009, and 2013. The last two updates were published in collaboration with the International Society for Bipolar Disorders (ISBD). These 2018 CANMAT and ISBD Bipolar Treatment Guidelines represent the significant advances in the field since the last full edition was published in 2005, including updates to diagnosis and management as well as new research into pharmacological and psychological treatments. These advances have been translated into clear and easy to use recommendations for first, second, and third‐ line treatments, with consideration given to levels of evidence for efficacy, clinical support based on experience, and consensus ratings of safety, tolerability, and treatment‐emergent switch risk. New to these guidelines, hierarchical rankings were created for first and second‐ line treatments recommended for acute mania, acute depression, and maintenance treatment in bipolar I disorder. Created by considering the impact of each treatment across all phases of illness, this hierarchy will further assist clinicians in making evidence‐based treatment decisions. Lithium, quetiapine, divalproex, asenapine, aripiprazole, paliperidone, risperidone, and cariprazine alone or in combination are recommended as first‐line treatments for acute mania. First‐line options for bipolar I depression include quetiapine, lurasidone plus lithium or divalproex, lithium, lamotrigine, lurasidone, or adjunctive lamotrigine. While medications that have been shown to be effective for the acute phase should generally be continued for the maintenance phase in bipolar I disorder, there are some exceptions (such as with antidepressants); and available data suggest that lithium, quetiapine, divalproex, lamotrigine, asenapine, and aripiprazole monotherapy or combination treatments should be considered first‐line for those initiating or switching treatment during the maintenance phase. In addition to addressing issues in bipolar I disorder, these guidelines also provide an overview of, and recommendations for, clinical management of bipolar II disorder, as well as advice on specific populations, such as women at various stages of the reproductive cycle, children and adolescents, and older adults. There are also discussions on the impact of specific psychiatric and medical comorbidities such as substance use, anxiety, and metabolic disorders. Finally, an overview of issues related to safety and monitoring is provided. The CANMAT and ISBD groups hope that these guidelines become a valuable tool for practitioners across the globe.

show abstract

Does cognitive function in older bipolar patients depend on recurrent or current mood symptoms?

Schouws

Korten

Beekman

et al. 2020

Int J Geriat Psychiatry

Self Cite

View full text Add to dashboard Cite

Background Cognitive impairment in patients with bipolar disorder (BD) is viewed as an integral part of the disorder that seems to be rather stable and even present in euthymic state. Current mood symptoms influence cognition negatively and multiple mood episodes could lead to more severe psychopathology and cognitive impairment, resulting in a hypothesized neuroprogressive course of BD. The influence of current mood symptoms and recurrent mood episodes on cognitive functioning warrants further exploration. Methods Cohort 1 included 20 hypomanic and 21 depressed older adults with bipolar disorder (OABD) of which 20 were reassessed in the euthymic state and 50 healthy subjects. Cohort 2 included 27 OABD who had no recurrent mood episodes during 5 years and 29 who had recurrent mood episodes during 5 years. Neuropsychological examination including tests for memory, executive function, attention and verbal fluency was performed repeatedly in all subjects. Results In cohort 1 cross‐sectional analyses showed that hypomanic, depressed and euthymic patients groups did not differ from each other with respect to their cognitive functioning, except for attention, which was poorer only in depressed patients. Regardless of mood state patients experienced significantly worse cognitive functioning compared to the healthy subjects. Within subject comparisons revealed that performance on memory tasks was worse in patients with current mood symptoms; depressed patients were more impaired in the learning condition and hypomanic patients were more impaired in delayed recall. In cohort 2 cognitive functioning was not different in patients with or without recurrence in 5 year follow‐up. Conclusions Although OABD had worse cognitive functioning than healthy subjects, there was a quite stable pattern of cognitive impairment, regardless of current or recurrent mood episodes. These results do not provide consistent support for the hypothesis of neuroprogression in BD.

show abstract

Five‐year follow‐up of cognitive impairment in older adults with bipolar disorder

Cited by 65 publications

References 29 publications

Longitudinal analysis of cognitive performances in recent‐onset and late‐life Bipolar Disorder: A systematic review and meta‐analysis

Longitudinal analysis of cognitive performances in recent‐onset and late‐life Bipolar Disorder: A systematic review and meta‐analysis

Canadian Network for Mood and Anxiety Treatments (CANMAT) and International Society for Bipolar Disorders (ISBD) 2018 guidelines for the management of patients with bipolar disorder

Does cognitive function in older bipolar patients depend on recurrent or current mood symptoms?

Contact Info

Product

Resources

About