Gildengers Ariel G, Butters Meryl A, Aizenstein Howard J, Emanuel James, Ding Tianyu, Anderson Stewart J, Becker James T, Lopez Oscar, Reynolds Charles F, Mulsant Benoit H
Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
Department of Biostatistics, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA, USA.
Can J Psychiatry. 2025 May 25:7067437251343295. doi: 10.1177/07067437251343295.
ObjectivesAn emerging literature has assessed cognition or imaging markers of brain health in in older age bipolar disorder (OABD). In this context, we conducted the first longitudinal study (to our knowledge) that assessed the relationship among cognition, mood symptoms, and imaging markers of brain health in OABD.Methods99 participants with OABD were enrolled, underwent baseline assessment, and were followed annually for up to 3 years. They completed comprehensive assessments that included evaluation of general medical status, vascular disease burden, mental status, cognitive performance. A subset of participants ( = 58) completed magnetic resonance imaging (MRI) at one or two time-points, yielding three measures of brain health: gray matter volume, fractional anisotropy (FA), and burden of white matter hyperintensities (WMH).ResultsGroup-based trajectory modelling (GBTM) of overall cognitive performance revealed two groups: a group with higher cognitive performance (63 of 99, 63.6%) and a group with lower cognitive performance (36 of 99, 36.4%). GBTM also revealed two groups based on each of the three imaging markers of brain health. The higher cognitive performance group was associated with the groups with higher measure of total gray matter or higher FA. We found no relationship between the cognitive groups and level of mood symptoms during longitudinal follow-up or WMH burden.ConclusionsIn this first longitudinal study of cognition, mood symptoms, and markers of brain health in OABD, cognitive performance was related to brain health and not to mood symptoms over a follow-up of up to three years. Almost two-thirds of participants with OABD had cognitive performance comparable to older adults without OABD. Larger future studies will need to replicate and extend these findings.
目的
新兴文献已对老年双相情感障碍（OABD）患者的认知或脑健康成像标志物进行了评估。在此背景下，我们开展了第一项纵向研究（据我们所知），评估OABD患者认知、情绪症状与脑健康成像标志物之间的关系。
方法
招募了99名OABD患者，进行基线评估，并每年随访长达3年。他们完成了全面评估，包括一般医疗状况、血管疾病负担、精神状态、认知表现的评估。一部分参与者（n = 58）在一个或两个时间点完成了磁共振成像（MRI），得出三项脑健康指标：灰质体积、分数各向异性（FA）和白质高信号（WMH）负担。
结果
基于组的总体认知表现轨迹模型（GBTM）显示出两组：认知表现较高的一组（99人中的63人，63.6%）和认知表现较低的一组（99人中的36人，36.4%）。GBTM还根据三项脑健康成像标志物中的每一项显示出两组。认知表现较高的组与总灰质测量值较高或FA较高的组相关。我们发现在纵向随访期间，认知组与情绪症状水平或WMH负担之间没有关系。
结论
在这项关于OABD患者认知、情绪症状和脑健康标志物的首次纵向研究中，在长达三年的随访期间，认知表现与脑健康相关，而与情绪症状无关。几乎三分之二的OABD患者的认知表现与无OABD的老年人相当。未来需要更大规模的研究来重复和扩展这些发现。
