Aprahamian Ivan, Ladeira Rodolfo B, Diniz Breno S, Forlenza Orestes V, Nunes Paula V
Laboratory of Neuroscience (LIM-27), Department and Institute of Psychiatry, Faculty of Medicine, University of Sao Paulo, Brazil.
Laboratory of Neuroscience (LIM-27), Department and Institute of Psychiatry, Faculty of Medicine, University of Sao Paulo, Brazil.
Am J Geriatr Psychiatry. 2014 Apr;22(4):389-97. doi: 10.1016/j.jagp.2012.08.013. Epub 2013 Feb 6.
BACKGROUND/OBJECTIVE: Cognitive impairment is a common feature of bipolar disorder (BD), with increased risk of developing dementia in late life. The aim of this study was to investigate the performance on cognitive screening tests in a sample of older adults with BD, as compared to non-BD subjects.
186 older adults (86 with BD and 100 without BD) were included. Patients were stratified according to cognitive performance (normal cognition, mild impairment, and dementia). The comparison group comprised healthy controls; subjects with cognitive impairment but no dementia (CIND); or patients with probable or possible Alzheimer disease (AD). Sixty-five subjects were cognitively unimpaired (35 BD), 65 had CIND (25 BD), and 56 AD (26 BD). In each of these levels of cognitive function, we compared the performance of BD and non-BD subjects on the Mini-Mental State Examination (MMSE), verbal fluency test (VFT), and the Clock Drawing Test (CDT).
Non-demented patients with BD had a slightly worse global cognitive performance as compared with healthy controls and patients with CIND, as shown by lower scores on the MMSE. Similarly, BD patients performed worse on the VFT, both in the normal cognition range and in the dementia range. Finally, demented BD patients had a significantly worse performance on the CDT as compared with patients with dementia due to AD.
Older adults with BD perform significantly worse on some cognitive screening tests as compared with those without BD across different levels of cognition.
背景/目的：认知障碍是双相情感障碍（BD）的常见特征，在晚年患痴呆症的风险增加。本研究的目的是调查与非BD受试者相比，老年BD患者样本在认知筛查测试中的表现。
纳入186名老年人（86名患有BD，100名未患BD）。患者根据认知表现（正常认知、轻度损害和痴呆）进行分层。比较组包括健康对照；有认知障碍但无痴呆（CIND）的受试者；或可能患有阿尔茨海默病（AD）的患者。65名受试者认知未受损（35名BD患者），65名患有CIND（25名BD患者），56名患有AD（26名BD患者）。在这些认知功能水平的每一组中，我们比较了BD和非BD受试者在简易精神状态检查表（MMSE）、语言流畅性测试（VFT）和画钟试验（CDT）中的表现。
与健康对照和CIND患者相比，未患痴呆的BD患者整体认知表现略差，MMSE得分较低表明了这一点。同样，BD患者在VFT中的表现也较差，无论是在正常认知范围内还是在痴呆范围内。最后，与AD所致痴呆患者相比，BD痴呆患者在CDT中的表现明显更差。
与不同认知水平的非BD患者相比，老年BD患者在一些认知筛查测试中的表现明显更差。
