Steeper aging-related declines in cognitive control processes among adults with bipolar disorders

Adriana Seelye, Paul Thuras, Bridget Doane, Christie Clason, Wendy VanVoorst, Snežana Urošević

Research output: Contribution to journalArticle

Abstract

Background: Little is known about the specificity of executive functioning (EF) decline in older adults with bipolar disorders (OABD), or the impact of bipolar disorders (BD) on the timing and slope of age-related declines in EF processes implicated in both BD etiology and normative aging—cognitive control (CC). This cross-sectional study investigated age-related CC decline in BD. Methods: Participants were 43 adults with BD (M age = 61.5, SD = 15.8; 86% male) and 45 Controls (M age = 65.2, SD = 12.2; 98% male). Two-way ANOVAs examined the effects of median-age-split and diagnostic groups on cognitive processes with established BD deficits–CC processes (mental flexibility and response inhibition), verbal learning, and verbal fluency. Results: The median-split-age-by-diagnostic-group interaction was significant for mental flexibility; OABD performed significantly worse than younger adults with BD and younger and older Controls. Exploratory multivariate adaptive regression spline characterized non-linear nature of aging-slope changes in mental flexibility for each diagnostic group, yielding an inflection point at older age and steeper subsequent decline in OABD versus Controls. Limitations: This study is limited by a small sample (particularly for select neuropsychological measures) of mostly Caucasian men and BD diagnoses based on clinical interview and medical records review. Conclusions: Compared to healthy older adults, OABD showed steeper age-related decline in mental flexibility—select EF processes that depend on the integrity of the CC system. Preliminary evidence links CC integrity to daily functioning in OABD; accelerated aging decline in CC may pose a mechanism for high risk of functional impairment and dementia in OABD.

Original languageEnglish (US)
Pages (from-to)595-602
Number of pages8
JournalJournal of Affective Disorders
Volume246
DOIs
StatePublished - Mar 1 2019

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Bipolar Disorder
Cognitive Dysfunction
Mental Processes
Verbal Learning
Medical Records
Dementia
Young Adult
Analysis of Variance
Age Groups
Cross-Sectional Studies
Interviews

Keywords

  • Aging
  • Bipolar disorders
  • Cognitive control
  • Neuropsychological tests

ASJC Scopus subject areas

  • Clinical Psychology
  • Psychiatry and Mental health

Cite this

Steeper aging-related declines in cognitive control processes among adults with bipolar disorders. / Seelye, Adriana; Thuras, Paul; Doane, Bridget; Clason, Christie; VanVoorst, Wendy; Urošević, Snežana.

In: Journal of Affective Disorders, Vol. 246, 01.03.2019, p. 595-602.

Research output: Contribution to journalArticle

Seelye, Adriana ; Thuras, Paul ; Doane, Bridget ; Clason, Christie ; VanVoorst, Wendy ; Urošević, Snežana. / Steeper aging-related declines in cognitive control processes among adults with bipolar disorders. In: Journal of Affective Disorders. 2019 ; Vol. 246. pp. 595-602.
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abstract = "Background: Little is known about the specificity of executive functioning (EF) decline in older adults with bipolar disorders (OABD), or the impact of bipolar disorders (BD) on the timing and slope of age-related declines in EF processes implicated in both BD etiology and normative aging—cognitive control (CC). This cross-sectional study investigated age-related CC decline in BD. Methods: Participants were 43 adults with BD (M age = 61.5, SD = 15.8; 86{\%} male) and 45 Controls (M age = 65.2, SD = 12.2; 98{\%} male). Two-way ANOVAs examined the effects of median-age-split and diagnostic groups on cognitive processes with established BD deficits–CC processes (mental flexibility and response inhibition), verbal learning, and verbal fluency. Results: The median-split-age-by-diagnostic-group interaction was significant for mental flexibility; OABD performed significantly worse than younger adults with BD and younger and older Controls. Exploratory multivariate adaptive regression spline characterized non-linear nature of aging-slope changes in mental flexibility for each diagnostic group, yielding an inflection point at older age and steeper subsequent decline in OABD versus Controls. Limitations: This study is limited by a small sample (particularly for select neuropsychological measures) of mostly Caucasian men and BD diagnoses based on clinical interview and medical records review. Conclusions: Compared to healthy older adults, OABD showed steeper age-related decline in mental flexibility—select EF processes that depend on the integrity of the CC system. Preliminary evidence links CC integrity to daily functioning in OABD; accelerated aging decline in CC may pose a mechanism for high risk of functional impairment and dementia in OABD.",
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