Similar Trajectory of Executive Functioning Performance over 5 years among individuals with Bipolar Disorder and Unaffected Controls using Latent Growth Modeling.
Executive Functioning (EF) deficits in bipolar disorder (BD) are commonly present regardless of mood state and therefore are considered core features of the illness. However, very little is known about the temporal stability of these deficits. We examined the natural course of EF over a five year period in BD and healthy control (HC) samples.



Using a 5-year longitudinal cohort, 91 individuals with BD and 17 HC were administered a battery of neuropsychological tests that captured four main areas of EF: Processing Speed with Interference Resolution, Verbal Fluency with Processing Speed, Inhibitory Control, and Conceptual Reasoning and Set Shifting. Evaluations occurred at study entry, one, and five years later.



Latent Growth Curve Modeling demonstrated that the BD group performed significantly worse in all EF areas than the HC group. Changes in EF from baseline to 5-year follow-up were similar across both diagnostic groups. Older age at baseline, above and beyond education and diagnosis, was associated with worse initial performance in EF. Being of older age was associated with greater decline in Processing Speed with Interference Resolution, and Verbal Fluency with Processing Speed. Higher education was marginally associated with a smaller declining slope for Processing Speed with Interference Resolution.



Executive functioning deficits in BD persist over time, and in the context of normative age-related decline, may place individuals at greater risk for cognitive disability as the disease progresses. Age and having a BD diagnosis together, however, do not accelerate executive functioning decline over time.
Department of Psychiatry, University of Michigan, Ann Arbor, Michigan, USA. Electronic address: karyan@umich.edu.
Kelly A
KA
Ryan
Department of Psychiatry, University of Michigan, Ann Arbor, Michigan, USA.
Shervin
S
Assari
Department of Psychiatry, University of Michigan, Ann Arbor, Michigan, USA.
Bethany D
BD
Pester
Department of Psychiatry, University of Michigan, Ann Arbor, Michigan, USA.
Kristin
K
Hinrichs
Department of Psychiatry, University of Michigan, Ann Arbor, Michigan, USA.
Kaley
K
Angers
Department of Psychiatry, University of Michigan, Ann Arbor, Michigan, USA.
Amanda
A
Baker
Department of Psychiatry, University of Michigan, Ann Arbor, Michigan, USA.
David F
DF
Marshall
Department of Psychiatry, University of Michigan, Ann Arbor, Michigan, USA.
Deborah
D
Stringer
Department of Psychiatry, Penn State College of Medicine, Hershey, PA, USA.
Erika F H
EF
Saunders
Department of Psychiatry, University of Michigan, Ann Arbor, Michigan, USA; Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA.
Masoud
M
Kamali
Department of Psychiatry, University of Michigan, Ann Arbor, Michigan, USA.
Melvin G
MG
McInnis
Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, USA.
Scott A
SA
Langenecker
D000328:Adult; D001714:Bipolar Disorder / Q000523:psychology*; D003071:Cognition; D003072:Cognition Disorders / Q000523:psychology; D015331:Cohort Studies; D056344:Executive Function; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D013997:Time Factors
Affective disorders; Bipolar disorder; Cognition; Neurodegenerative