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Executive Function Among Older Adults With Bipolar Disorder: A GAGE-BD Analysis
Federica Klaus1, Erin Appiah2, Izabela G Barbosa3
1Department of Psychiatry (FK, ANS, LTE), University of California San Diego, San Diego, CA.
Summary
Older adults with bipolar disorder (BD) exhibit significant executive function deficits compared to healthy individuals. These deficits are linked to increased symptom severity, older age, and poorer daily functioning.
Area of Science:
- Neuroscience
- Gerontology
- Psychiatry
Background:
- Executive function impairments significantly contribute to disability in older adults with bipolar disorder (OABD).
- Understanding these deficits is crucial for developing targeted interventions.
Purpose of the Study:
- To compare executive function between OABD and age-matched healthy comparators (HC).
- To examine the associations of executive function with age, symptom severity, global cognition, and daily functioning within the OABD group.
Main Methods:
- A cross-sectional analysis was conducted using a large, harmonized archival dataset from 12 international OABD studies.
- Executive function was assessed using the Trail Making Test B (TMT-B) completion time in 614 OABD patients (≥50 years) and 192 HC.
- Covariates included age, gender, education, study site, medications, and psychomotor speed.
Main Results:
- Executive function was significantly worse in OABD compared to HC, even after controlling for psychomotor speed (p < 0.001).
- In OABD, poorer executive function correlated with older age (p = 0.001), antipsychotic use (p < 0.001), worse global cognition (p < 0.001), and reduced daily functioning (p < 0.001).
- Less severe manic symptoms were associated with better executive function (p < 0.001).
Conclusions:
- Executive dysfunction is a notable characteristic of OABD, linked to various demographic and clinical factors.
- Further longitudinal research is needed to clarify the impact of executive function impairment on daily life.
- Findings support the need for personalized interventions targeting specific patient subgroups based on executive function deficits.
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