This study has explored the influence of cognitive reserve on preservation of specific cognitive abilities over time in BP. The BP group did not demonstrate accelerated cognitive decline over 5 years compared to the HC group. Although the trajectory of cognitive change over time was similar between BP patients and HCs, higher overall intellectual ability may be a protective factor against cognitive decline, particularly for BP patients.
Objectives
Cognitive dysfunction is a key feature of bipolar disorder (BD).
However, not much is known about its temporal stability, as some studies
have demonstrated a neurodegenerative model in BD while others have shown no
change in cognitive functioning over time. Building upon our prior work
which examined the natural course of executive functioning, the current
study aimed to investigate the natural course of memory, emotion processing,
and fine motor dexterity over a five year period in BD and healthy control
(HC) samples.
Methods
Using a five-year longitudinal cohort, 90 individuals with BD and 17
HCs were administered a battery of neuropsychological tests at study
baseline, 1 year, and 5 years after study entry that captured four areas of
cognitive performance: visual memory, auditory memory, emotion processing,
and fine motor dexterity.
Results
Latent Growth Curve Modeling showed no group differences in the
slopes of any of the cognitive factors between the BD and HC groups. Age at
baseline was negatively associated with visual memory, emotion processing,
and fine motor dexterity. Education level was positively associated with
auditory and visual memory and fine motor. Female gender was negatively
associated with emotion processing.
Conclusions
Extending our prior work on longitudinal evaluation of executive
functioning, individuals with BD show similar linear change in others areas
of cognitive functioning including memory, emotion processing, and fine
motor dexterity as compared to unaffected, healthy controls. Age, education,
and gender may have some differential effects on cognitive changes.
Abstract-Individuals with the same neurological conditions do not necessarily manifest the same behavioral presentation, which suggests differences in resilience and vulnerability among individuals, a concept known as cognitive reserve. This study sought to explore the relationship among cognitive reserve, executive functioning, and health and safety judgment in a sample of older adult inpatients in an extended medical care unit at a Veterans Health Administration hospital. We hypothesized that cognitive reserve, as determined by an estimate of premorbid intellectual ability, would act as a protective factor against poor judgment in older adults with executive dysfunction. Participants included 200 Veterans who completed a comprehensive neuropsychological assessment, including measures of health and safety judgment, executive functioning, global cognitive functioning, and premorbid intellectual ability. After controlling for global cognitive functioning, executive functioning abilities did not have an effect on judgment abilities among those with high estimated intellectual ability. However, executive functioning had a significant effect on judgment abilities among those with low estimated intellectual ability. Our results suggest that intact executive functioning is critical for making appropriate health and safety decisions for patients with lower measured intellectual abilities and provide further support for the cognitive reserve model. Clinical implications are also discussed.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.