Physical multimorbidity is not independently associated with cognitive performance in patients with older-age bipolar disorder (OABD)

International Psychogeriatrics, vol. 37, pp. 100070

Abstract

OBJECTIVES: Cognitive impairment is common in bipolar disorder (BD), especially in older age (≥50 years). Underlying causes of BD-related cognitive impairment are not fully elucidated. This study investigates the association between physical multimorbidity and subjective and objective cognitive performance in patients with older age bipolar disorder (OABD). DESIGN: Cross-sectional design. SETTING: Dutch Older Bipolars (DOBi) dynamic cohort. PARTICIPANTS: 170 outpatients with BD aged ≥ 50 years. MEASUREMENTS: Chronic physical diseases were assessed in a structured interview. Objective cognitive performance was measured with neuropsychological tests, subjective cognitive performance with the Cognitive Failures Questionnaire (CFQ). Linear regression analyses were performed between multimorbidity, defined as two or more affected physical disease domains, and 1) objective cognitive performance, 2) subjective cognitive functioning, and 3) four cognitive domain scores (attention, learning and memory, verbal fluency, executive functioning). Analyses were hierarchically adjusted for demographic, lifestyle, and psychiatric characteristics. RESULTS: Multimorbidity was significantly associated with a lower composite cognitive score (B=-0.205, p = 0.040), but after full adjustment statistical significance disappeared (B=-0.044, p = 0.633). Controlled for demographics only, multimorbidity was not significantly associated with higher CFQ (B=6.009, p = 0.053). Multimorbidity was associated with worse executive functioning (B=-0.279, p = 0.018), but statistical significance disappeared after full adjustment (B=-0.085, p = 0.469). CONCLUSIONS: In OABD physical multimorbidity is not independently associated with poorer cognitive performance and subjective functioning. Rather, shared risk factors, such as demographics, psychiatric characteristics, and lifestyle factors might lead to both the presence of physical diseases and worse cognitive performance in OABD.

Authors 7

1. Alexandra J.M. Beunders corresponding

   Amsterdam UMC Location Vrije Universiteit Amsterdam · Amsterdam Public Health · GGZ inGeest

   Affiliation as printed

   GGZ inGeest Specialized Mental Health Care, Amsterdam, the Netherlands; Amsterdam UMC location Vrije Universiteit Amsterdam, Department of Psychiatry, Amsterdam, the Netherlands; Amsterdam Public Health, Mental Health program, Amsterdam, the Netherlands. Electronic address: alexandra.beunders@ggzingeest.nl

2. Nicole C. M. Korten

   Amsterdam UMC Location Vrije Universiteit Amsterdam

   Affiliation as printed

   Amsterdam UMC location Vrije Universiteit Amsterdam, Department of Psychiatry, Amsterdam, the Netherlands; Northwest Clinics, Department of Medical Psychology, Alkmaar, the Netherlands

3. Mariska Bot

   Amsterdam UMC Location Vrije Universiteit Amsterdam · Amsterdam Public Health

   Affiliation as printed

   Amsterdam UMC location Vrije Universiteit Amsterdam, Department of Psychiatry, Amsterdam, the Netherlands; Amsterdam Public Health, Mental Health program, Amsterdam, the Netherlands

4. Sigfried N. T. M. Schouws

   Amsterdam UMC Location Vrije Universiteit Amsterdam · GGZ inGeest

   Affiliation as printed

   GGZ inGeest Specialized Mental Health Care, Amsterdam, the Netherlands; Amsterdam UMC location Vrije Universiteit Amsterdam, Department of Psychiatry, Amsterdam, the Netherlands

5. Ralph Kupka

   Amsterdam UMC Location Vrije Universiteit Amsterdam · GGZ inGeest

   Affiliation as printed

   GGZ inGeest Specialized Mental Health Care, Amsterdam, the Netherlands; Amsterdam UMC location Vrije Universiteit Amsterdam, Department of Psychiatry, Amsterdam, the Netherlands

6. Melis Orhan Aachen Faculty of Social Sciences Institute of Psychology, Leiden University

   Leiden University

   Affiliation as printed

   Faculty of Social Sciences, Institute of Psychology, Leiden University, Leiden, the Netherlands

7. Annemiek Dols

   Amsterdam Neuroscience · University Medical Center Utrecht · Amsterdam UMC Location Vrije Universiteit Amsterdam

   Affiliation as printed

   Amsterdam UMC location Vrije Universiteit Amsterdam, Department of Psychiatry, Amsterdam, the Netherlands; Department of Psychiatry, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht, the Netherlands; Amsterdam Neuroscience, Mood, Anxiety, Psychosis, Sleep & Stress, Amsterdam, the Netherlands