Cognition in older age bipolar disorder: An analysis of archival data across the globe

Federica Klaus¹, Hui Xin Ng², Izabela G Barbosa³, Alexandra Beunders⁴, Farren Briggs⁵, Katherine E Burdick⁶, Annemieke Dols⁷, Orestes Forlenza⁸, Ariel Gildengers⁹, Caitlin Millett¹⁰, Benoit H Mulsant¹¹, Melis Orhan¹², Tarek K Rajji¹¹, Soham Rej¹³, Martha Sajatovic¹⁴, Kaylee Sarna¹⁴, Sigfried Schouws¹⁵, Ashley Sutherland¹⁶, Antonio L Teixeira¹⁷, Joy A Yala¹⁴, Lisa T Eyler¹⁶; GAGE-BD Investigators

Affiliations

¹ Department of Psychiatry, University of California San Diego, San Diego, CA, USA; Desert-Pacific Mental Illness Research Education and Clinical Center, VA San Diego Healthcare System, San Diego, CA, USA. Electronic address: fklaus@ucsd.edu.
² Department of Psychiatry, University of California San Diego, San Diego, CA, USA.
³ Departamento de Psiquiatria, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.
⁴ GGZ inGeest Specialized Mental Health Care, Department of Old Age Psychiatry, Amsterdam, the Netherlands; Amsterdam UMC, Amsterdam Public Health research institute, Amsterdam, the Netherlands.
⁵ Department of Public Health Sciences, Miller School of Medicine, University of Miami, Miami, FL, USA.
⁶ Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
⁷ Amsterdam UMC, Amsterdam Neuroscience, Mood, Anxiety, Psychosis, Sleep & Stress Program, Amsterdam, the Netherlands; Department of Psychiatry, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht, the Netherlands.
⁸ Laboratory of Neuroscience (LIM-27), Department and Institute of Psychiatry, HCFMUSP, Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil.
⁹ Department of Psychiatry, University of Pittsburgh School of Medicine, Western Psychiatric Hospital, USA.
¹⁰ Institute of Behavioral Science, The Feinstein Institutes of Medical Research, New York, USA.
¹¹ Department of Psychiatry, Center for Addiction & Mental Health, University of Toronto, Toronto, Canada.
¹² Institute of Clinical Psychology, Leiden University, Leiden, the Netherlands.
¹³ Department of Psychiatry, Jewish General Hospital/Lady Davis Institute, McGill University, Montreal, Canada.
¹⁴ Case Western Reserve University School of Medicine (MS), University Hospitals Cleveland Medical Center, Cleveland, OH, USA.
¹⁵ GZZ inGeest Specialized Mental Health Care, Department of Old Age Psychiatry, Amsterdam, the Netherlands.
¹⁶ Department of Psychiatry, University of California San Diego, San Diego, CA, USA; Desert-Pacific Mental Illness Research Education and Clinical Center, VA San Diego Healthcare System, San Diego, CA, USA.
¹⁷ Department of Psychiatry and Behavioral Sciences, University of Texas/McGovern Medical School, Houston, TX, USA; Faculdade Santa Casa BH, Belo Horizonte, Minas Gerais, Brazil.

PMID: 38548199
DOI: 10.1016/j.jad.2024.03.126

Cognition in older age bipolar disorder: An analysis of archival data across the globe

Federica Klaus et al. J Affect Disord. 2024.

. 2024 Jun 15:355:231-238.

doi: 10.1016/j.jad.2024.03.126. Epub 2024 Mar 26.

Authors

Affiliations

¹ Department of Psychiatry, University of California San Diego, San Diego, CA, USA; Desert-Pacific Mental Illness Research Education and Clinical Center, VA San Diego Healthcare System, San Diego, CA, USA. Electronic address: fklaus@ucsd.edu.
² Department of Psychiatry, University of California San Diego, San Diego, CA, USA.
³ Departamento de Psiquiatria, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.
⁴ GGZ inGeest Specialized Mental Health Care, Department of Old Age Psychiatry, Amsterdam, the Netherlands; Amsterdam UMC, Amsterdam Public Health research institute, Amsterdam, the Netherlands.
⁵ Department of Public Health Sciences, Miller School of Medicine, University of Miami, Miami, FL, USA.
⁶ Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
⁷ Amsterdam UMC, Amsterdam Neuroscience, Mood, Anxiety, Psychosis, Sleep & Stress Program, Amsterdam, the Netherlands; Department of Psychiatry, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht, the Netherlands.
⁸ Laboratory of Neuroscience (LIM-27), Department and Institute of Psychiatry, HCFMUSP, Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil.
⁹ Department of Psychiatry, University of Pittsburgh School of Medicine, Western Psychiatric Hospital, USA.
¹⁰ Institute of Behavioral Science, The Feinstein Institutes of Medical Research, New York, USA.
¹¹ Department of Psychiatry, Center for Addiction & Mental Health, University of Toronto, Toronto, Canada.
¹² Institute of Clinical Psychology, Leiden University, Leiden, the Netherlands.
¹³ Department of Psychiatry, Jewish General Hospital/Lady Davis Institute, McGill University, Montreal, Canada.
¹⁴ Case Western Reserve University School of Medicine (MS), University Hospitals Cleveland Medical Center, Cleveland, OH, USA.
¹⁵ GZZ inGeest Specialized Mental Health Care, Department of Old Age Psychiatry, Amsterdam, the Netherlands.
¹⁶ Department of Psychiatry, University of California San Diego, San Diego, CA, USA; Desert-Pacific Mental Illness Research Education and Clinical Center, VA San Diego Healthcare System, San Diego, CA, USA.
¹⁷ Department of Psychiatry and Behavioral Sciences, University of Texas/McGovern Medical School, Houston, TX, USA; Faculdade Santa Casa BH, Belo Horizonte, Minas Gerais, Brazil.

PMID: 38548199
DOI: 10.1016/j.jad.2024.03.126

Abstract

Background: Cognitive deficits in bipolar disorder (BD) impact functioning and are main contributors to disability in older age BD (OABD). We investigated the difference between OABD and age-comparable healthy comparison (HC) participants and, among those with BD, the associations between age, global cognitive performance, symptom severity and functioning using a large, cross-sectional, archival dataset harmonized from 7 international OABD studies.

Methods: Data from the Global Aging and Geriatric Experiments in Bipolar Disorder (GAGE-BD) database, spanning various standardized measures of cognition, functioning and clinical characteristics, were analyzed. The sample included 662 euthymic to mildly symptomatic participants aged minimum 50years (509 BD, 153 HC), able to undergo extensive cognitive testing. Linear mixed models estimated associations between diagnosis and global cognitive performance (g-score, harmonized across studies), and within OABD between g-score and severity of mania and depressive symptoms, duration of illness and lithium use and of global functioning.

Results: After adjustment for study cohort, age, gender and employment status, there was no significant difference in g-score between OABD and HC, while a significant interaction emerged between employment status and diagnostic group (better global cognition associated with working) in BD. Within OABD, better g-scores were associated with fewer manic symptoms, higher education and better functioning.

Limitations: Cross-sectional design and loss of granularity due to harmonization.

Conclusion: More research is needed to understand heterogenous longitudinal patterns of cognitive change in BD and understand whether particular cognitive domains might be affected in OABD in order to develop new therapeutic efforts for cognitive dysfunction OABD.

Keywords: Functioning; Global cognition; Older age bipolar disorder.

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Conflict of interest statement

Declaration of competing interest FK reports no conflict of interest. Dr. Sajatovic has research grants from Otsuka, the International Society for Bipolar Disorders (ISBD), NIH, and the Centers for Disease Control and Prevention (CDC). She is a consultant to Otsuka, Janssen, Lundbeck, Teva, Neurelis and has received publication royalties from Springer Press, Johns Hopkins University Press, Oxford Press and UpToDate. Dr. Rej has salary support from the Fonds de Recherche Quebec - Sante, Grant from Mitacs, Steering Committee for Abbvie, Shareholder of Aifred Health. Dr. Mulsant holds and receives support from the Labatt Family Chair in Biology of Depression in Late-Life Adults at the University of Toronto. During the past five years, he has received research support from Brain Canada, the Canadian Institutes of Health Research, the CAMH Foundation, the Patient-Centered Outcomes Research Institute (PCORI), the US National Institute of Health (NIH), Capital Solution Design LLC (software used in a study founded by CAMH Foundation), and HAPPYneuron (software used in a study founded by Brain Canada). He has also been an unpaid consultant to Myriad Neuroscience.

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Cognition in older age bipolar disorder: An analysis of archival data across the globe

Affiliations

Cognition in older age bipolar disorder: An analysis of archival data across the globe

Authors

Affiliations

Abstract

Conflict of interest statement

References

Publication types

MeSH terms

LinkOut - more resources

Full Text Sources

Medical