title: Neurocognitive functioning in early-onset and late-onset older patients with euthymic bipolar disorder.
abstract: OBJECTIVE
  Most neurocognitive studies have not taken into account the fact that older patients with bipolar disorder (BD) are a heterogeneous population. The main goal of this study was to compare neurocognitive performance and extrapyramidal symptoms in older patients with early-onset BD (EO-BD) and late-onset BD (LO-BD).
  
  
  METHODS
  Euthymic older patients with EO-BD (n = 20), LO-BD (n = 20), and healthy controls (n = 20) were evaluated with traditional clinical instruments and measures of exposure to psychotropic drugs, as well as extrapyramidal symptoms. All subjects completed an extensive neuropsychological battery.
  
  
  RESULTS
  Patients with EO-BD showed poorer performance than healthy controls in two measures of verbal memory and two measures of executive functions, whereas patients with LO-BD exhibited lower performance scores than healthy controls in almost all of the measures assessed. Impairments in the LO-BD group included even neurocognitive domains typically spared in mixed-age patients. Additionally, there was a trend toward displaying higher extrapyramidal symptoms in the LO-BD group compared with both EO-BD and healthy control groups. In both patient groups, psychosocial functioning was related with executive dysfunction and extrapyramidal symptoms.
  
  
  CONCLUSIONS
  Patients with LO-BD may have more extensive and severe cognitive impairments, as well as higher vulnerability to extrapyramidal symptoms, compared with patients with EO-BD. Cognitive-motor disturbances may help to explain impairments in daily functioning among older patients with EO-BD and LO-BD during remission.
authors.affiliation: Bipolar Disorder Program, Institute of Neurosciences, Favaloro University, Buenos Aires, Argentina.
authors.forename: Diego J
authors.initials: DJ
authors.lastname: Martino
authors.forename: Sergio A
authors.initials: SA
authors.lastname: Strejilevich
authors.forename: Facundo
authors.initials: F
authors.lastname: Manes
mesh_terms: D000328:Adult; D017668:Age of Onset; D000704:Analysis of Variance; D001714:Bipolar Disorder / Q000503:physiopathology / Q000523:psychology*; D003072:Cognition Disorders / Q000209:etiology / Q000523:psychology*; D039721:Diagnostic and Statistical Manual of Mental Disorders; D056344:Executive Function / Q000502:physiology; D005260:Female; D006801:Humans; D008297:Male; D008568:Memory / Q000502:physiology; D008875:Middle Aged; D012917:Social Adjustment; D055815:Young Adult