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Neurocognitive functioning in early-onset and late-onset older patients with euthymic bipolar disorder

Authors

  • Diego J. Martino,

    1. Bipolar Disorder Program, Institute of Neurosciences, Favaloro University, Buenos Aires, Argentina
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  • Sergio A. Strejilevich,

    Corresponding author
    1. Institute of Cognitive Neurology (INECO), Buenos Aires, Argentina
    • Bipolar Disorder Program, Institute of Neurosciences, Favaloro University, Buenos Aires, Argentina
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  • Facundo Manes

    1. Bipolar Disorder Program, Institute of Neurosciences, Favaloro University, Buenos Aires, Argentina
    2. Institute of Cognitive Neurology (INECO), Buenos Aires, Argentina
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S. A. Strejilevich, E-mail: sstrejilevich@ffavaloro.org

Abstract

Objective

Most neurocognitive studies have not taken into account the fact that older patients with bipolar disorder (BD) are a heterogeneous population. The main goal of this study was to compare neurocognitive performance and extrapyramidal symptoms in older patients with early-onset BD (EO-BD) and late-onset BD (LO-BD).

Methods

Euthymic older patients with EO-BD (n = 20), LO-BD (n = 20), and healthy controls (n = 20) were evaluated with traditional clinical instruments and measures of exposure to psychotropic drugs, as well as extrapyramidal symptoms. All subjects completed an extensive neuropsychological battery.

Results

Patients with EO-BD showed poorer performance than healthy controls in two measures of verbal memory and two measures of executive functions, whereas patients with LO-BD exhibited lower performance scores than healthy controls in almost all of the measures assessed. Impairments in the LO-BD group included even neurocognitive domains typically spared in mixed-age patients. Additionally, there was a trend toward displaying higher extrapyramidal symptoms in the LO-BD group compared with both EO-BD and healthy control groups. In both patient groups, psychosocial functioning was related with executive dysfunction and extrapyramidal symptoms.

Conclusions

Patients with LO-BD may have more extensive and severe cognitive impairments, as well as higher vulnerability to extrapyramidal symptoms, compared with patients with EO-BD. Cognitive–motor disturbances may help to explain impairments in daily functioning among older patients with EO-BD and LO-BD during remission. Copyright © 2012 John Wiley & Sons, Ltd.

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