Year: 2008
Type: article
Study design: Observational Study
Abstract: In spite of the high prevalence of dementia among elderly patients with bipolar disorder, there is very little prospective information on the cognitive outcome of this disorder. Cognitive impairment is associated with a poorer prognosis in bipolar disorder, leading to a greater number of affective and psychotic episodes, and increased risk of institutionalization. The objective of the present study is to determine cognitive decline in a cohort of elderly patients with bipolar disorder, non-demented at baseline. Twenty-two elderly patients with bipolar disorder meeting DSM-IV criteria, and 25 healthy controls were longitudinally assessed at the Institute of Psychiatry, University of Sao Paulo, Brazil. Patients and controls were matched for age (66.3±4.3 and 67.2±6.8 years, p=0.57), education (7.1±4.9 and 8.7±4.1 years of schooling; p=0.24), and cognitive state (all non-demented). Subjects were yearly assessed with the CAMCOG, a brief but comprehensive cognitive battery comprising orientation, language, memory, attention, praxis, gnosis, calculation and abstraction sub-scores. Patients were euthymic at the time of cognitive evaluation (HAMD-21 ≤ 7 and YMRS ≤ 4). Baseline CAMCOG scores for patients and controls were respectively 90.5±7.8 and 93.1±6.0 (p=0.20). After one year of follow-up, the total CAMCOG scores were 90.3±7.6 and 93.9±8.0 (p=0.12), and after two years 90.9±8.0 and 95.0±6.8 (p=0.065) respectively. No significant differences on cognitive outcome were found between patients with and without bipolar disorder, even though there was a trend of increasing difference of the cognitive outcome between the two groups. Larger samples and longer follow-up periods may be necessary to detect incident deficits. The existence of unrecognized cognitive disturbances in these patients may have important implications in the adherence to medication and other therapeutic interventions, and the early identification of such dysfunctions may result beneficial to the global outcome.
Source: Alzheimer s & Dementia
Institution: Universidade de São Paulo
Language: English
Subfield: Psychiatry and Mental health
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W2058918521