Neuropsychological functioning, age, and medication adherence in bipolar disorder

Area of Science:

• Neuroscience
• Psychiatry
• Clinical Psychology

Background:

• Medication adherence is crucial for managing bipolar disorder (BD).
• Factors influencing adherence in BD are complex and not fully understood.
• The impact of neuropsychological functioning on adherence, particularly considering age, requires further investigation.

Purpose of the Study:

• To examine the relationship between neuropsychological functioning and medication adherence in bipolar disorder patients.
• To specifically investigate the influence of age on this relationship.
• To identify age-specific predictors of low adherence in BD.

Main Methods:

• A cross-sectional study of 353 euthymic bipolar disorder patients (type I, II, NOS) from a French cohort.
• Patients were divided into two age groups: 16-46 and 47-71 years.
• Standardized clinical and neuropsychological assessments were performed, with adherence categorized using the Medication Adherence Rating Scale.

Main Results:

• In younger patients, low adherence was associated with fewer hospitalizations, shorter illness duration, and higher adverse effects.
• In older patients, low adherence was linked to fewer hospitalizations and higher adverse effects.
• Poor inhibition performance was a significant predictor of low adherence exclusively in older patients.

Conclusions:

• An age-specific relationship exists between cognitive function and medication adherence in bipolar disorder.
• Impaired inhibition is a key predictor of non-adherence in older BD patients.
• Therapeutic strategies for improving adherence in BD should be adapted to patient age.