Section of Psychiatry, Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, Italy; IRCCS Ospedale Policlinico San Martino, Genoa, Italy; Institute of Psychiatry, Department of Biomedical and Specialty Surgical Sciences, University of Ferrara, Ferrara, Italy.
Section of Psychiatry, Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, Italy; Institute for Geriatric Psychiatry, Weill Cornell Medicine, White Plains, New York, NY, USA.
J Affect Disord. 2019 Oct 1;257:166-172. doi: 10.1016/j.jad.2019.07.052. Epub 2019 Jul 5.
Late Life Bipolar Disorder (LLBD) is associated with a high prevalence of cognitive impairments, but few studies have examined their risk factors and clinical correlates METHODS: Participants with bipolar disorder older than 60 (n = 86) were recruited from psychiatric outpatient and inpatients units. Patients were assessed with various instruments, including the Clinical Dementia Rating scale, the Montreal Cognitive Assessment and the Cumulative Illness Rating Scale. The distribution of disorder-specific and general risk factors was compared between patients with LLBD plus cognitive impairments (mild cognitive impairment or dementia) and those with LLBD but no cognitive impairment. Analyses were first conducted at the bivariate level, then using multiple regression. The association with disability, aggressive behavior and suicidal ideation was also explored.
Cognitive impairments in LLBD were associated with a diagnosis of type 1 bipolar disorder (OR = 6.40, 95%CI: 1.84 - 22.31, p = 0.004), fewer years of education (OR = 0.79, 95%CI: 0.69 - 0.91, p = 0.001) and higher severity of physical diseases (OR 26.54, 95%CI: 2.07 - 340.37, p = 0.01). Moreover, cognitive impairments were associated with an increased likelihood of disability and recent aggressive behavior, but not suicidal ideation.
retrospective design, conflation of MCI and dementia, not all subjects were in euthymia CONCLUSIONS: In LLBD, the presence of cognitive impairments was associated with a diagnosis of type I bipolar disorder, lower education and more severe physical comorbidities. In turn, MCI or dementia were associated with increased disability and aggressive behavior. These findings may aid the identification of patients at risk for cognitive deterioration in everyday clinical practice.
老年期双相障碍（LLBD）与认知障碍的高患病率相关，但很少有研究探讨其危险因素和临床相关性。
从精神科门诊和住院患者中招募年龄在 60 岁以上的双相障碍患者（n=86）。使用各种工具评估患者，包括临床痴呆评定量表、蒙特利尔认知评估和累积疾病评分量表。比较 LLBD 伴认知障碍（轻度认知障碍或痴呆）和 LLBD 但无认知障碍的患者之间的特定疾病和一般危险因素的分布。首先进行双变量分析，然后进行多元回归分析。还探讨了与残疾、攻击行为和自杀意念的关联。
LLBD 的认知障碍与 1 型双相障碍的诊断（OR=6.40，95%CI：1.84-22.31，p=0.004）、受教育年限较少（OR=0.79，95%CI：0.69-0.91，p=0.001）和更高的躯体疾病严重程度（OR 26.54，95%CI：2.07-340.37，p=0.01）相关。此外，认知障碍与残疾和近期攻击行为的可能性增加相关，但与自杀意念无关。
回顾性设计、MCI 和痴呆的合并、并非所有受试者均处于病情稳定期。
在 LLBD 中，认知障碍的存在与 1 型双相障碍的诊断、较低的教育程度和更严重的躯体共病有关。反过来，MCI 或痴呆与残疾和攻击行为的增加有关。这些发现可能有助于在日常临床实践中识别认知恶化的风险患者。
