背景:双相情感障碍(BD)的认知障碍影响功能,是老年BD(OABD)残疾的主要原因。我们调查了OABD和年龄可比的健康比较(HC)参与者之间的差异,在那些有BD的人中,年龄之间的关联,全球认知表现,症状严重程度和功能使用大,横截面,从7项国际OABD研究中统一得出的档案数据集。
方法:来自双相情感障碍全球衰老和老年实验(GAGE-BD)数据库的数据,跨越各种标准化的认知衡量标准,功能和临床特征,进行了分析。样本包括662名年龄最小为50岁的轻度症状参与者(509BD,153HC),能够进行广泛的认知测试。线性混合模型估计诊断和全球认知表现之间的关联(g分数,跨研究协调),在OABD范围内,g评分与躁狂症和抑郁症状的严重程度之间,疾病持续时间和锂的使用以及全球功能。
结果:调整研究队列后,年龄,性别和就业状况,OABD和HC之间的g评分没有显着差异,而BD的就业状况与诊断组(与工作相关的更好的全球认知)之间出现了显着的相互作用。在OABD内,更好的g评分与更少的躁狂症状相关,更高的教育和更好的功能。
结论:横截面设计和由于协调而导致的粒度损失。
结论:需要更多的研究来了解BD认知变化的异质性纵向模式,并了解OABD中特定认知领域是否可能受到影响,以便开发新的OABD认知功能障碍的治疗方法。
BACKGROUND: Cognitive deficits in bipolar disorder (BD) impact functioning and are main contributors to disability in older age BD (OABD). We investigated the difference between OABD and age-comparable healthy comparison (HC) participants and, among those with BD, the associations between age, global cognitive performance, symptom severity and functioning using a large, cross-sectional, archival dataset harmonized from 7 international OABD studies.
METHODS: Data from the Global Aging and Geriatric Experiments in Bipolar Disorder (GAGE-BD) database, spanning various standardized measures of cognition, functioning and clinical characteristics, were analyzed. The sample included 662 euthymic to mildly symptomatic participants aged minimum 50years (509 BD, 153 HC), able to undergo extensive cognitive testing. Linear mixed models estimated associations between diagnosis and global cognitive performance (g-score, harmonized across studies), and within OABD between g-score and severity of mania and depressive symptoms, duration of illness and lithium use and of global functioning.
RESULTS: After adjustment for study cohort, age, gender and employment status, there was no significant difference in g-score between OABD and HC, while a significant interaction emerged between employment status and diagnostic group (better global cognition associated with working) in BD. Within OABD, better g-scores were associated with fewer manic symptoms, higher education and better functioning.
CONCLUSIONS: Cross-sectional design and loss of granularity due to harmonization.
CONCLUSIONS: More research is needed to understand heterogenous longitudinal patterns of cognitive change in BD and understand whether particular cognitive domains might be affected in OABD in order to develop new therapeutic efforts for cognitive dysfunction OABD.