Executive functioning of older adults with bipolar disorder

Abstract

Objectives: Despite their impact on daily functioning, we have limited understanding of the executive functioning of older adults with bipolar disorder (OABD). Even less is known about the possible differences in the executive functioning of OABD and older adults with unipolar depression (OADEP). Methods: After excluding acutely ill patients, the executive functioning of OABD was compared to that of OADEP and healthy controls (n = 22, n = 20, n = 22; respectively). Cognitive insight, a sub-domain of executive functioning, was operationalized as the discrepancy between the participants' self-reported cognitive functioning and appraisals that were made by their care partners. To complement the cognitive profiling, the groups were compared in information processing speed, verbal memory, and visual-spatial memory. Results: OABD were impaired in several cognitive domains compared to healthy controls, most prominently in executive functioning and memory. OABD had poorer executive functioning and visual-spatial memory than OADEP. The findings also tentatively point toward intact cognitive insight among OABD, while OADEP seem to have a heightened level of awareness of their cognitive impairment. Conclusions: OABD have a unique profile of cognitive impairment compared to OADEP. It is characterized by a more severe cognitive impairment, accompanied by relatively intact cognitive insight. The findings may help clarify the cognitive profile of OABD and assist in the development of cognitive rehabilitation programs tailored to their needs. They should, however, be considered preliminary and await further research.

Older Age Bipolar Disorder

“…In a recent cross-sectional study (N ¼ 432 bipolar disorder patients), older age was associated with a selective cognitive decline in bipolar disorder in attention when compared with age-matched healthy controls [63]. OABD patients show a more severely impaired cognitive profile when compared with older patients with unipolar depression or healthy controls [64,65]. A recent DOBi study suggests that cognitive performance is multifactorial, as cardiovascular risk, benzodiazepine use, number of episodes, late-onset, and five or more psychiatric admissions were associated with cognitive performance [66].…”

Older age bipolar disorder

“…In a recent cross-sectional study ( N = 432 bipolar disorder patients), older age was associated with a selective cognitive decline in bipolar disorder in attention when compared with age-matched healthy controls [ 63 ]. OABD patients show a more severely impaired cognitive profile when compared with older patients with unipolar depression or healthy controls [ 64 , 65 ]. A recent DOBi study suggests that cognitive performance is multifactorial, as cardiovascular risk, benzodiazepine use, number of episodes, late-onset, and five or more psychiatric admissions were associated with cognitive performance [ 66 ].…”