Allostatic load but not medical burden predicts memory performance in late‐life bipolar disorder

Vaccarino, Sophie R.; Rajji, Tarek K.; Gildengers, Ariel; Waters, Sarah E.S.; Butters, Meryl A.; Menon, Mahesh; Blumberger, Daniel M.; Voineskos, Aristotle N.; Miranda, Dielle; Mulsant, Benoit H.

doi:10.1002/gps.4829

Cited by 16 publications

(13 citation statements)

References 42 publications

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“…It is important to highlight that in the case of our results of delayed memory, the recall of both verbal and visual stimuli contributed to that difference, because visual memory was assessed in only two studies. 30,31 Consequently, we could not know for certain if this impairment is due to verbal memory, visual memory, or both. Nevertheless, the analysis of heterogeneity showed higher values (I 2 ) in verbal learning and in inhibition, suggesting that these results should be interpreted with caution.…”

Section: Discussionmentioning

confidence: 99%

“…All cognitive test were transferred to the appropriate domain; that is, we decided to include all tests, regardless of whether they were used by the other studies or not, since the objective was to achieve a comprehensive cognitive profile across cognitive domains. However, it should be noted that, for delayed recall, visual and verbal memory domains were merged due to the scarcity of data from the former, where only two studies assessed visual memory 30,31 …”

Section: Methodsmentioning

confidence: 99%

“…However, it should be noted that, for delayed recall, visual and verbal memory domains were merged due to the scarcity of data from the former, where only two studies assessed visual memory. 30,31 Finally, the cognitive domains analyzed comprised the following tests:…”

Section: Neuropsychological Variablesmentioning

confidence: 99%

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Cognition in older adults with bipolar disorder: An ISBD task force systematic review and meta‐analysis based on a comprehensive neuropsychological assessment

et al. 2022

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Objectives:We aim to characterize the cognitive performance in euthymic older adults with bipolar disorder (OABD) through a comprehensive neuropsychological assessment to obtain a detailed neuropsychological profile. Methods:We conducted a systematic search in MEDLINE/Pubmed, Cochrane, and PsycInfo databases. Original studies assessing cognitive function in OABD (age ≥50 years ) containing, at a minimum, the domains of attention/processing speed, memory, and executive functions were included. A random-effects meta-analysis was conducted to summarize differences between patients and matched controls in each cognitive domain. We also conducted meta-regressions to estimate the impact of clinical and socio-demographic variables on these differences.Results: Eight articles, providing data for 328 euthymic OABD patients and 302 healthy controls, were included in the meta-analysis. OABD showed worse performance in comparison with healthy controls, with large significant effect sizes (Hedge's g from −0.77 to −0.89; p < 0.001) in verbal learning and verbal and visual delayed memory. They also displayed statistically significant deficits, with moderate effect size, in processing speed, working memory, immediate memory, cognitive flexibility, verbal fluency, psychomotor function, executive functions, attention, inhibition, and recognition (Hedge's g from −0.52 to −0.76; p < 0.001), but not in language and visuoconstruction domains. None of the examined variables were associated with these deficits. Conclusions:Cognitive dysfunction is present in OABD, with important deficits in almost all cognitive domains, especially in the memory domain. Our results highlight the importance of including a routine complete neuropsychological assessment in OABD and also considering therapeutic strategies in OABD.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Cognition in older adults with bipolar disorder: An ISBD task force systematic review and meta‐analysis based on a comprehensive neuropsychological assessment

et al. 2022

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“…We have previously examined younger and older groups of HC and people with schizophrenia [56][57][58]. We have also examined people with BD using 50 as the age cutoff [59]. In other studies, we have modeled age as a continuous variable [60].…”

Section: Discussionmentioning

confidence: 99%

Brain structure, cognition, and brain age in schizophrenia, bipolar disorder, and healthy controls

Shahab

Mulsant

Lévesque

et al. 2018

Neuropsychopharmacol.

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126

108

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Schizophrenia and bipolar disorder (BD) may be disorders of accelerated aging. Direct comparison of healthy aging populations with schizophrenia and BD patients across the adult lifespan may help inform this theory. In total, 225 individuals (91 healthy controls, 81 schizophrenia, 53 euthymic BD) underwent 3T T1-weighted magnetic resonance imaging, diffusion tensor imaging, and cognitive testing. We analyzed associations among age, diagnosis, and cognition with cortical thickness and fractional anisotropy (FA) using general linear models. We then assessed "brain age" using a random forest algorithm, which was also assessed in an independent sample (n = 147). Participants with schizophrenia had lower cortical thickness and FA compared with the other two groups, most prominently in fronto-temporal circuitry. These brain changes were more evident in younger participants than in older ones, yet were associated with cognitive performance independent of diagnosis. Predicted age was 8 years greater than chronological age in individuals with schizophrenia in the first sample and 6 years greater in the second sample. Predicted and chronological age were not different in BD. Differences in brain circuitry are present from illness onset most prominently in schizophrenia and to a lesser extent in BD. These results support a non-progressive "early hit" hypothesis/etiology of illness in the major psychoses. Brain age differences support the hypothesized early aging mechanism in schizophrenia but not in BD.

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“…In a study on older adults, higher levels of allostatic load were associated with both affective and somatic de pressive symptoms [280] and were prospectively associ ated with depressive symptoms at a 3year followup in another [279]. Among older euthymic bipolar disorder patients [289], allostatic load was found to be associated with delayed memory performance.…”

Section: Mood and Anxiety Disordersmentioning

confidence: 98%

Allostatic Load and Its Impact on Health: A Systematic Review

Guidi

Lucente

Sonino

et al. 2020

Psychother Psychosom

642

466

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Introduction: Allostatic load refers to the cumulative burden of chronic stress and life events. It involves the interaction of different physiological systems at varying degrees of activity. When environmental challenges exceed the individual ability to cope, then allostatic overload ensues. Allostatic load is identified by the use of biomarkers and clinical criteria. Objective: To summarize the current knowledge on allostatic load and overload and its clinical implications based on a systematic review of the literature. Methods: PubMed, PsycINFO, Web of Science, and the Cochrane Library were searched from inception to December 2019. A manual search of the literature was also performed, and reference lists of the retrieved articles were examined.We considered only studies in which allostatic load or overload were adequately described and assessed in either clinical or non-clinical adult populations. Results: A total of 267 original investigations were included. They encompassed general population studies, as well as clinical studies on consequences of allostatic load/overload on both physical and mental health across a variety of settings. Conclusions: The findings indicate that allostatic load and overload are associated with poorer health outcomes. Assessment of allostatic load provides support to the understanding of psychosocial determinants of health and lifestyle medicine. An integrated approach that includes both biological markers and clinimetric criteria is recommended.

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Allostatic load but not medical burden predicts memory performance in late‐life bipolar disorder

Cited by 16 publications

References 42 publications

Cognition in older adults with bipolar disorder: An ISBD task force systematic review and meta‐analysis based on a comprehensive neuropsychological assessment

Cognition in older adults with bipolar disorder: An ISBD task force systematic review and meta‐analysis based on a comprehensive neuropsychological assessment

Brain structure, cognition, and brain age in schizophrenia, bipolar disorder, and healthy controls

Allostatic Load and Its Impact on Health: A Systematic Review

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