title: Five-year follow-up of cognitive impairment in older adults with bipolar disorder.
abstract: OBJECTIVE
  To date, cognitive impairment has been thought to be an integral part of bipolar disorder. In clinical staging models, cognitive impairment is one of the hallmarks to define the clinical stage and it plays an important role in identifying the risk factors for progression to later stages of the illness. It is important to examine neurocognitive performance over longer periods to test the hypothesis of neuroprogression of bipolar disorder.
  
  
  METHODS
  A comprehensive neuropsychological test battery was applied at baseline and five years later to 56 euthymic older outpatients with bipolar disorder (mean age = 68.35 years, range: 60-90 years) and to a demographically matched sample of 44 healthy subjects. A group-by-time repeated measures multivariate analysis of variance was performed to measure changes over time for the two groups. The impact of baseline illness characteristics on the intra-individual change in neurocognitive performance within the bipolar disorder group was studied by using logistic regression analysis.
  
  
  RESULTS
  At baseline and at follow-up, patients with bipolar disorder performed worse on all neurocognitive measures compared to the matched healthy subjects. However, there was no significant group-by-time interaction between the patients with bipolar disorder and the comparison group.
  
  
  CONCLUSIONS
  Although older patients with bipolar disorder had worse cognitive function than healthy subjects, they did not have greater cognitive decline over a five-year period. The change in acquired cognitive impairment of patients with bipolar disorder might parallel the cognitive development as seen in normal aging.
authors.affiliation: Department of Old Age Psychiatry, GGZ inGeest, Amsterdam, The Netherlands.
authors.forename: Sigfried N T M
authors.initials: SN
authors.lastname: Schouws
authors.affiliation: Department of Old Age Psychiatry, GGZ inGeest, Amsterdam, The Netherlands.|Department of Psychiatry, EMGO Institute of Care and Health Research VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: Hannie C
authors.initials: HC
authors.lastname: Comijs
authors.affiliation: Department of Old Age Psychiatry, GGZ inGeest, Amsterdam, The Netherlands.
authors.forename: Annemieke
authors.initials: A
authors.lastname: Dols
authors.affiliation: Department of Psychiatry, EMGO Institute of Care and Health Research VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: Aartjan T F
authors.initials: AT
authors.lastname: Beekman
authors.affiliation: Department of Old Age Psychiatry, GGZ inGeest, Amsterdam, The Netherlands.
authors.forename: Max L
authors.initials: ML
authors.lastname: Stek
mesh_terms: D000368:Aged; D000375:Aging / Q000523:psychology*; D000704:Analysis of Variance; D001714:Bipolar Disorder / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D003071:Cognition; D003072:Cognition Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology / Q000523:psychology; D003710:Demography; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D009483:Neuropsychological Tests; D010045:Outpatients / Q000523:psychology / Q000706:statistics & numerical data
keywords: bipolar disorder; cognition; old age