Risk factors for cognitive impairment in elderly bipolar patients.
OBJECTIVE
Cognitive impairment in elderly bipolar patients persists during euthymic state, yet the aetiology of such impairment is not well understood. The objective of this study is to identify factors contributing to cognitive impairment in elderly patients with bipolar disorder.


METHODS
119 older patients (age >60) with bipolar I or II disorder in a euthymic state were extensively tested on cognitive functioning including attention, memory, visuoconstruction, executive function and verbal fluency with regard to potential risk factors.


RESULTS
Regression analysis shows that health related factors, medication and illness characteristics are associated with cognitive impairment in several cognitive domains: attention, memory, visuoconstruction, executive function and verbal fluency. More vascular burden factors are related to poorer outcome of cognitive functioning. Patients with lithium pharmacotherapy performed worse compared to those with other mood stabilizers, but this was no longer significant in multivariate analysis.


CONCLUSIONS
In elderly bipolar patients, more vascular risk factors and more hospital admissions are associated with more cognitive impairment.
Schouws
Sigfried N T M
SN
GGZ inGeest, Amsterdam, The Netherlands. s.schouws@ggzingeest.nl
Stek
Max L
ML
Comijs
Hannie C
HC
Beekman
Aartjan T F
AT
D000368:Aged; D000369:Aged, 80 and over; D000927:Anticonvulsants / Q000009:adverse effects / Q000627:therapeutic use; D018692:Antimanic Agents / Q000009:adverse effects / Q000627:therapeutic use; D001288:Attention; D001714:Bipolar Disorder / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology / Q000523:psychology; D002318:Cardiovascular Diseases / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D003072:Cognition Disorders / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology / Q000523:psychology; D015897:Comorbidity; D056344:Executive Function; D005260:Female; D006801:Humans; D016651:Lithium Carbonate / Q000009:adverse effects / Q000627:therapeutic use; D008297:Male; D011939:Mental Recall; D008875:Middle Aged; D009483:Neuropsychological Tests / Q000706:statistics & numerical data; D010364:Pattern Recognition, Visual; D011379:Prognosis; D011594:Psychometrics; D012307:Risk Factors; D014705:Verbal Behavior
D000927:Anticonvulsants; D018692:Antimanic Agents; D016651:Lithium Carbonate