Numerous studies have been conducted assessing the neurocognitive impairments associated with bipolar (BD). It is theorized that these impairments occur when symptoms of BD first appear, usually in adolescence or early adulthood. However, people with BD can have normal life expectancies, thus raising the question of how these impairments affect overall cognitive capacities in later years. As people age, they experience a normal and gradual decline in cognitive abilities, memory, information processing and even language. They also often experience declines in their physical abilities which can impact their instrumental activities of daily living (IADLs). Although there is extensive research on the effects of BD episodes on various domains across the lifespan, little attention has been given to how older adults with BD are impacted in areas of cognitive abilities and IADLs.
To address this gap, Ariel G. Gildengers of the University of Pittsburgh, School of Medicine’s Department of Psychiatry recently conducted a study involving 47 individuals with BD, all over the age of 50. She compared their cognitive and executive functions and their IADLs to those of 22 BD individuals of similar ages who do not have BD. Gildengers evaluated all of the participants at baseline and two more times over the next two years. She found that even though the participants with BD had less cognitive resources at baseline, they did not have steeper declines than the control participants over the course of the two years. In fact, the declines in both groups were reflective of normal cognitive decreases that accompany aging.
Gildengers did note that the BD individuals had poorer overall executive functioning, memory capacity, and, in particular, slower information processing than the controls. Language deficits were relatively equal among the two groups. The results of this study show that even though BD adults may not be at risk for disproportionate cognitive reductions as they age, they may be more vulnerable to cognitive illnesses such as dementia earlier in life than individuals without equal levels of cognitive impairment. She added, “Hence, interventions targeting cognitive function need to be focused early on to prevent cognitive deterioration.”
Gildengers, A. G., et al. (2013). Two-year course of cognitive function and instrumental activities of daily living in older adults with bipolar disorder: Evidence for neuroprogression? Psychological Medicine 43.4 (2013): 801-11. ProQuest. Web.
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