Cognitive impairment in late life bipolar disorder: Risk factors and clinical outcomes

Murri, Martino Belvederi; Respino, Matteo; Proietti, Luca; Bugliani, Michele; Pereira, Beatriz Oliveira; D'Amico, Emiliano; Sangregorio, Filippo; Villa, Veronica; Trinchero, Valentina; Brugnolo, Andrea; Girtler, Nicola; Nobili, Flavio; Amore, Mario

doi:10.1016/j.jad.2019.07.052

Cited by 23 publications

(13 citation statements)

References 62 publications

(83 reference statements)

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“…Belvederi Murri et al drew interesting conclusions from their study. They found that cognitive impairments linked with BD were associated with an increased likelihood of disability and recent aggressive behavior but not suicidal thoughts (48).…”

Section: Mood Disordersmentioning

confidence: 99%

Mental Disorders, Cognitive Impairment and the Risk of Suicide in Older Adults

2021

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More than 600 million people are aged 60 years and over are living in the world. The World Health Organization estimates that this number will double by 2025 to 2 billion older people. Suicide among people over the age of 60 is one of the most acute problems. The factors strongly associated with suicide are mentioned: physical illnesses, such as cancer, neurologic disorder, pain, liver disease, genital disorders, or rheumatoid disorders. Moreover, neurologic conditions, especially stroke, may affect decision-making processes, cognitive capacity, and language deficit. In addition to dementia, the most common mental disorders are mood and anxiety disorders. A common symptom of these disorders in the elderly is cognitive impairment. This study aimed to present the relationship between cognitive impairment due to dementia, mood disorders and anxiety, and an increased risk of suicide among older people. Dementia is a disease where the risk of suicide is significant. Many studies demonstrated that older adults with dementia had an increased risk of suicide death than those without dementia. Similar conclusions apply to prodromal dementia Depression is also a disease with a high risk of suicide. Many researchers found that a higher level of depression was associated with suicide attempts and suicide ideation. Bipolar disorder is the second entity in mood disorders with an increased risk of suicide among the elderly. Apart from suicidal thoughts, bipolar disorder is characterized by high mortality. In the group of anxiety disorders, the most significant risk of suicide occurs when depression is present. In turn, suicide thoughts are more common in social phobia than in other anxiety disorders. Suicide among the elderly is a serious public health problem. There is a positive correlation between mental disorders such as dementia, depression, bipolar disorder, or anxiety and the prevalence of suicide in the elderly. Therefore, the elderly should be comprehensively provided with psychiatric and psychological support.

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Section: Mood Disordersmentioning

confidence: 99%

Mental Disorders, Cognitive Impairment and the Risk of Suicide in Older Adults

2021

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“…Also, the current study assessed cognitive performance based on an extensive neuropsychological assessment and investigated overall cognitive performance as well as performance on specific cognitive domains. This is in contrast to several previous studies on cognition in OABD, which used one or two neuropsychological tests, a clinical cognitive rating scale or an ICD dementia diagnosis instead of a full NPA 22,45,46 …”

Section: Discussionmentioning

confidence: 84%

“…This is in contrast to several previous studies on cognition in OABD, which used one or two neuropsychological tests, a clinical cognitive rating scale or an ICD dementia diagnosis instead of a full NPA. 22 , 45 , 46 …”

Section: Discussionmentioning

confidence: 99%

Cognitive performance in older‐age bipolar disorder: Investigating psychiatric characteristics, cardiovascular burden and psychotropic medication

Beunders

Kemp

Korten

et al. 2021

Acta Psychiatr Scand

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Objective This study aimed to explore a large range of candidate determinants of cognitive performance in older‐age bipolar disorder (OABD). Methods A cross‐sectional study was performed in 172 BD patients aged ≥50 years. Demographics, psychiatric characteristics and psychotropic medication use were collected using self‐report questionnaires and structured interviews. The presence of cardiovascular risk factors was determined by combining information from structured interviews, physical examination and laboratory assessments. Cognitive performance was investigated by an extensive neuropsychological assessment of 13 tests, covering the domains of attention, learning/ memory, verbal fluency and executive functioning. The average of 13 neuropsychological test Z‐scores resulted in a composite cognitive score. A linear multiple regression model was created using forward selection with the composite cognitive score as outcome variable. Domain cognitive scores were used as secondary outcome variables. Results The final multivariable model (N = 125), which controlled for age and education level, included number of depressive episodes, number of (hypo)manic episodes, late onset, five or more psychiatric admissions, lifetime smoking, metabolic syndrome and current use of benzodiazepines. Together, these determinants explained 43.0% of the variance in composite cognitive score. Late onset and number of depressive episodes were significantly related to better cognitive performance whereas five or more psychiatric admissions and benzodiazepine use were significantly related to worse cognitive performance. Conclusion Psychiatric characteristics, cardiovascular risk and benzodiazepine use are related to cognitive performance in OABD. Cognitive variability in OABD thus seems multifactorial. Strategies aimed at improving cognition in BD should include cardiovascular risk management and minimizing benzodiazepine use.

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“…Among the major psychiatric syndromes, bipolar disorder is most frequently associated with dementia (35); among major dementias, bvFTD is most commonly preceded by psychiatric symptoms (7). Although a recent meta-analysis of longitudinal (1-9 years) studies did not find significant differences in rates of cognitive decline between patients with bipolar disorder and control subjects (36), many other studies from around the world have reported an increased risk of dementia among cohorts of patients with bipolar disorder, particularly those with bipolar I disorder (37,38), compared with control subjects, with hazard ratios ranging from 2.36 (37,(39)(40)(41)(42)(43)(44). The dementia syndrome in these patients may be more similar to bvFTD than other dementias, such as Alzheimer's disease (45).…”

Section: Discussionmentioning

confidence: 94%