Alexandra J M Beunders, Nicole C M Korten, Mariska Bot, Sigfried N T M Schouws, Ralph W Kupka, Melis Orhan, Annemiek Dols
{"title":"Physical multimorbidity is not independently associated with cognitive performance in patients with older-age bipolar disorder (OABD).","authors":"Alexandra J M Beunders, Nicole C M Korten, Mariska Bot, Sigfried N T M Schouws, Ralph W Kupka, Melis Orhan, Annemiek Dols","doi":"10.1016/j.inpsyc.2025.100070","DOIUrl":null,"url":null,"abstract":"<p><strong>Objectives: </strong>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).</p><p><strong>Design: </strong>Cross-sectional design.</p><p><strong>Setting: </strong>Dutch Older Bipolars (DOBi) dynamic cohort.</p><p><strong>Participants: </strong>170 outpatients with BD aged ≥ 50 years.</p><p><strong>Measurements: </strong>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.</p><p><strong>Results: </strong>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).</p><p><strong>Conclusions: </strong>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.</p>","PeriodicalId":14368,"journal":{"name":"International psychogeriatrics","volume":" ","pages":"100070"},"PeriodicalIF":4.6000,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"International psychogeriatrics","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.inpsyc.2025.100070","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"GERIATRICS & GERONTOLOGY","Score":null,"Total":0}
引用次数: 0
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).
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.
目的：认知障碍在双相情感障碍（BD）中很常见，尤其是在老年人（≥50岁）中。bd相关认知障碍的潜在原因尚未完全阐明。本研究探讨了老年双相情感障碍（OABD）患者身体多病与主客观认知表现之间的关系。设计：横断面设计。背景：荷兰老年双相情感障碍（DOBi）动态队列。参与者：170例年龄≥50岁的BD门诊患者。测量方法：通过结构化访谈对慢性身体疾病进行评估。客观认知表现采用神经心理测试，主观认知表现采用认知失败问卷（CFQ）。多病（定义为两个或多个受影响的身体疾病领域）与1)客观认知表现、2)主观认知功能和3)四个认知领域得分（注意力、学习和记忆、语言流畅性、执行功能）之间进行线性回归分析。根据人口统计学、生活方式和精神病学特征对分析进行分层调整。结果：多病与较低的综合认知评分有显著相关（B=-0.205, p = 0.040），但经完全调整后无统计学意义（B=-0.044, p = 0.633）。仅在人口统计学控制下，多病与较高的CFQ无显著相关性（B=6.009, p = 0.053）。多病与较差的执行功能相关（B=-0.279, p = 0.018），但完全调整后无统计学意义（B=-0.085, p = 0.469）。结论：在OABD中，身体多病与较差的认知表现和主观功能并不独立相关。相反，共同的风险因素，如人口统计学、精神病学特征和生活方式因素，可能导致OABD中身体疾病的存在和更差的认知表现。
期刊介绍：
A highly respected, multidisciplinary journal, International Psychogeriatrics publishes high quality original research papers in the field of psychogeriatrics. The journal aims to be the leading peer reviewed journal dealing with all aspects of the mental health of older people throughout the world. Circulated to over 1,000 members of the International Psychogeriatric Association, International Psychogeriatrics also features important editorials, provocative debates, literature reviews, book reviews and letters to the editor.
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