Cognition in older adults with bipolar disorder: An ISBD task force systematic review and meta‐analysis based on a comprehensive neuropsychological assessment

Abstract

Objectives:We aim to characterize the cognitive performance in euthymic older adults with bipolar disorder (OABD) through a comprehensive neuropsychological assessment to obtain a detailed neuropsychological profile. Methods:We conducted a systematic search in MEDLINE/Pubmed, Cochrane, and PsycInfo databases. Original studies assessing cognitive function in OABD (age ≥50 years ) containing, at a minimum, the domains of attention/processing speed, memory, and executive functions were included. A random-effects meta-analysis was conducted to summarize differences between patients and matched controls in each cognitive domain. We also conducted meta-regressions to estimate the impact of clinical and socio-demographic variables on these differences.Results: Eight articles, providing data for 328 euthymic OABD patients and 302 healthy controls, were included in the meta-analysis. OABD showed worse performance in comparison with healthy controls, with large significant effect sizes (Hedge's g from −0.77 to −0.89; p < 0.001) in verbal learning and verbal and visual delayed memory. They also displayed statistically significant deficits, with moderate effect size, in processing speed, working memory, immediate memory, cognitive flexibility, verbal fluency, psychomotor function, executive functions, attention, inhibition, and recognition (Hedge's g from −0.52 to −0.76; p < 0.001), but not in language and visuoconstruction domains. None of the examined variables were associated with these deficits. Conclusions:Cognitive dysfunction is present in OABD, with important deficits in almost all cognitive domains, especially in the memory domain. Our results highlight the importance of including a routine complete neuropsychological assessment in OABD and also considering therapeutic strategies in OABD.

No Sex Differences in Self-Reported Childhood Maltreatment in Major Depressive and Bipolar Disorders: A Retrospective Study

“…Our samples had an elderly mean age, and patients admitted to Villa San Benedetto Menni Hospital for a psychiatric rehabilitation program typically have chronic psychiatric conditions of long durations. Therefore, it is conceivable that the well-documented cognitive impairment associated with MDD and BD may have compromised retrospective recall of CM, particularly in older patients [ 47 , 48 , 49 ]. Unfortunately, the sample size did not allow us to analyze the CM distribution across age cohorts in order to achieve a more comprehensive understanding of this topic.…”

Are There Sex Differences in Self-Reported Childhood Maltreatment in Major Depressive and Bipolar Disorders? A Retrospective Cross-Sectional Study

“…Our samples had an elderly mean age, and patients admitted to Villa San Benedetto Menni Hospital for a psychiatric rehabilitation program typically have chronic psychiatric conditions with long disease duration. Therefore, it is conceivable that the well-documented cognitive impairment associated with MDD and BD may have compromised retrospective recall of CM, particularly in older patients [47][48][49]. Unfortunately, the sample size did not allow us to analyze the CM distribution across age cohorts in order to achieve a more comprehensive understanding of this topic.…”

The neuropsychology of mood disorders.

“…Some children and adolescents do have an earlier onset of BD, however, and their pattern of cognitive deficits is very similar to that of adults with typical onset, with reported difficulties in multiple information-processing domains and in reward processing (Cahill et al, 2009). A recent meta-analysis of older adults with BD found the largest effect sizes for verbal learning, delayed memory, and immediate memory, in that order (Montejo et al, 2022). Medium effect sizes were seen for executive functioning, processing speed, working memory, psychomotor speed, and attention.…”