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

Int J Geriatr Psychiatry. 2013 Feb;28(2):142-8. doi: 10.1002/gps.3801. Epub 2012 Mar 26.


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.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Age of Onset
  • Analysis of Variance
  • Bipolar Disorder / physiopathology
  • Bipolar Disorder / psychology*
  • Cognition Disorders / etiology
  • Cognition Disorders / psychology*
  • Diagnostic and Statistical Manual of Mental Disorders
  • Executive Function / physiology
  • Female
  • Humans
  • Male
  • Memory / physiology
  • Middle Aged
  • Social Adjustment
  • Young Adult