Cognitive Functioning and Instrumental Activities of Daily Living in Late-Life Bipolar Disorder

Neurocognitive impairment in bipolar disorder patients: functional implications

“…Of the 13 remaining reports, one was excluded for not exploring correlations between cognitive and functional domains, yielding 12 studies suitable for further analysis (1,3,4,23,(28)(29)(30)(31)(32)(33)(34)(35). These 12 studies provided 13 sets of correlations between cognitive and functional status, including eight studies involving euthymic BPD patients (3,4,(29)(30)(31)(32)(33)(34) and five involving BPD patients in non-euthymic or uncertain mood states (1,3,23,28,35). The latter five studies included BPD patients either recently hospitalized (23,28) or still in major depression, mania, or hypomania (1, 3), or in unspecified mood states (35).…”

“…Specifically, in studies of euthymic BPD patients (Table 2A), estimated premorbid IQ was assessed in 6 ⁄ 8 studies (3,4,(29)(30)(31)(32), executive function in six (3,4,30,(32)(33)(34), verbal learning and memory in six (3,4,29,(32)(33)(34), attention, concentration, mental tracking, information processing speed, and immediate memory in five (3,4,30,31,33), verbal fluency or language in four (4,30,31,33), visuospatial performance in three (29,31,33), and psychomotor speed in two studies (3,31). Euthymic BPD patients performed less well than matched healthy controls in these cognitive measures in 7 ⁄ 8 studies.…”

“…Euthymic BPD patients performed less well than matched healthy controls in these cognitive measures in 7 ⁄ 8 studies. Their impaired domains involved verbal learning and memory in four studies (4,29,32,34), executive functioning in three (4,33,34), and attention, concentration, mental tracking, and information processing speed in three (31)(32)(33).…”

“…c Participants had cognitive testing when Ôsufficiently stableÕ after hospitalization; at one-year follow-up they were rated for functional status [Multidimensional Scale for Independent Living To assess functional status in euthymic BPD patients, 5 ⁄ 8 studies (3,4,30,32,34) used the Global Assessment of Functioning (GAF) Scale (38); three of these (4, 32, 34) reported explicitly that only social and occupational functioning, and not mood symptoms, were considered, two relied on patient self-assessment on psychosocial functioning rating scales (29,31), and only one used performance-based measures to assess the instrumental activities of daily living [IADL (33)]. Functional domains considered were vocational and educational activities, household maintenance, level of independent living, and quality of family and social relationships.…”

Acetylcholinesterase inhibitors and memantine in bipolar disorder: A systematic review and best evidence synthesis of the efficacy and safety for multiple disease dimensions

“…Furthermore, BD has been associated with cognitive dysfunction (Torres et al, 2007). Data in older people with BD showing worse information processing speed and executive functioning than age-matched controls (Gildengers et al, 2007) could suggest that these individuals are at higher risk of cognitive problems particularly during late-life. In this context, the use of memantine might be appropriate since this drug is commonly used in moderate-severe forms of Alzheimer's disease and seems to have neuroprotective effects (Lopes et al, 2013).…”