The Heterogeneity of Longitudinal Cognitive Decline in Euthymic Bipolar I Disorder With Clinical Characteristics and Functional Outcomes
We characterized the heterogeneity and risk factors of cognitive decline in euthymic bipolar disorder (BD), and their magnitude of associations with subjective daily functions. In this retrospective cohort, BD type I patients ( N = 128) were followed for an average of 6.5 years. Intelligence quotien...
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| Published in | Frontiers in psychiatry Vol. 12; p. 684813 |
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| Main Authors | , , , , , , , , , , |
| Format | Journal Article |
| Language | English |
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21.07.2021
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| Abstract | We characterized the heterogeneity and risk factors of cognitive decline in euthymic bipolar disorder (BD), and their magnitude of associations with subjective daily functions. In this retrospective cohort, BD type I patients (
N
= 128) were followed for an average of 6.5 years. Intelligence quotient (IQ) at index date was recorded, and premorbid IQ was estimated. We used Brief Assessment of Cognition in Affective Disorders (BAC-A) to assess cognition at follow-up. We evaluated current functions with World Health Organization Disability Assessment Schedule 2.0. Clinical and sociodemographic factors were examined for their independent effects on longitudinal cognitive decline. In addition, we employed multivariate adaptive regression spline to detect inflection points for the nature of slope changes in cognitive decline among BD patients. During follow-up years, 21 BD patients (16.4%) showed longitudinal cognitive decline. In cognitive decline group, all cognitive domains of BAC-A were significantly worsened. We found that density of episodes with psychotic features was an independent risk factor for cognitive decline after adjusted for age, gender and dose of mood stabilizer. After the age of 42 years, a steeper cognitive change was observed in the cognitive decline group. The correlation pattern between cognitive domains and functional outcomes differed between patients with and without cognitive decline. The present study characterized cognitive heterogeneity longitudinally in BD patients. As density of episodes play roles for cognitive decline, our results emphasize the importance of relapse prevention. Our findings provide hints for future personalized interventions and facilitating genetic and biological studies for dissecting the heterogeneity of bipolar illness. |
|---|---|
| AbstractList | We characterized the heterogeneity and risk factors of cognitive decline in euthymic bipolar disorder (BD), and their magnitude of associations with subjective daily functions. In this retrospective cohort, BD type I patients (
N
= 128) were followed for an average of 6.5 years. Intelligence quotient (IQ) at index date was recorded, and premorbid IQ was estimated. We used Brief Assessment of Cognition in Affective Disorders (BAC-A) to assess cognition at follow-up. We evaluated current functions with World Health Organization Disability Assessment Schedule 2.0. Clinical and sociodemographic factors were examined for their independent effects on longitudinal cognitive decline. In addition, we employed multivariate adaptive regression spline to detect inflection points for the nature of slope changes in cognitive decline among BD patients. During follow-up years, 21 BD patients (16.4%) showed longitudinal cognitive decline. In cognitive decline group, all cognitive domains of BAC-A were significantly worsened. We found that density of episodes with psychotic features was an independent risk factor for cognitive decline after adjusted for age, gender and dose of mood stabilizer. After the age of 42 years, a steeper cognitive change was observed in the cognitive decline group. The correlation pattern between cognitive domains and functional outcomes differed between patients with and without cognitive decline. The present study characterized cognitive heterogeneity longitudinally in BD patients. As density of episodes play roles for cognitive decline, our results emphasize the importance of relapse prevention. Our findings provide hints for future personalized interventions and facilitating genetic and biological studies for dissecting the heterogeneity of bipolar illness. We characterized the heterogeneity and risk factors of cognitive decline in euthymic bipolar disorder (BD), and their magnitude of associations with subjective daily functions. In this retrospective cohort, BD type I patients (N = 128) were followed for an average of 6.5 years. Intelligence quotient (IQ) at index date was recorded, and premorbid IQ was estimated. We used Brief Assessment of Cognition in Affective Disorders (BAC-A) to assess cognition at follow-up. We evaluated current functions with World Health Organization Disability Assessment Schedule 2.0. Clinical and sociodemographic factors were examined for their independent effects on longitudinal cognitive decline. In addition, we employed multivariate adaptive regression spline to detect inflection points for the nature of slope changes in cognitive decline among BD patients. During follow-up years, 21 BD patients (16.4%) showed longitudinal cognitive decline. In cognitive decline group, all cognitive domains of BAC-A were significantly worsened. We found that density of episodes with psychotic features was an independent risk factor for cognitive decline after adjusted for age, gender and dose of mood stabilizer. After the age of 42 years, a steeper cognitive change was observed in the cognitive decline group. The correlation pattern between cognitive domains and functional outcomes differed between patients with and without cognitive decline. The present study characterized cognitive heterogeneity longitudinally in BD patients. As density of episodes play roles for cognitive decline, our results emphasize the importance of relapse prevention. Our findings provide hints for future personalized interventions and facilitating genetic and biological studies for dissecting the heterogeneity of bipolar illness.We characterized the heterogeneity and risk factors of cognitive decline in euthymic bipolar disorder (BD), and their magnitude of associations with subjective daily functions. In this retrospective cohort, BD type I patients (N = 128) were followed for an average of 6.5 years. Intelligence quotient (IQ) at index date was recorded, and premorbid IQ was estimated. We used Brief Assessment of Cognition in Affective Disorders (BAC-A) to assess cognition at follow-up. We evaluated current functions with World Health Organization Disability Assessment Schedule 2.0. Clinical and sociodemographic factors were examined for their independent effects on longitudinal cognitive decline. In addition, we employed multivariate adaptive regression spline to detect inflection points for the nature of slope changes in cognitive decline among BD patients. During follow-up years, 21 BD patients (16.4%) showed longitudinal cognitive decline. In cognitive decline group, all cognitive domains of BAC-A were significantly worsened. We found that density of episodes with psychotic features was an independent risk factor for cognitive decline after adjusted for age, gender and dose of mood stabilizer. After the age of 42 years, a steeper cognitive change was observed in the cognitive decline group. The correlation pattern between cognitive domains and functional outcomes differed between patients with and without cognitive decline. The present study characterized cognitive heterogeneity longitudinally in BD patients. As density of episodes play roles for cognitive decline, our results emphasize the importance of relapse prevention. Our findings provide hints for future personalized interventions and facilitating genetic and biological studies for dissecting the heterogeneity of bipolar illness. We characterized the heterogeneity and risk factors of cognitive decline in euthymic bipolar disorder (BD), and their magnitude of associations with subjective daily functions. In this retrospective cohort, BD type I patients (N = 128) were followed for an average of 6.5 years. Intelligence quotient (IQ) at index date was recorded, and premorbid IQ was estimated. We used Brief Assessment of Cognition in Affective Disorders (BAC-A) to assess cognition at follow-up. We evaluated current functions with World Health Organization Disability Assessment Schedule 2.0. Clinical and sociodemographic factors were examined for their independent effects on longitudinal cognitive decline. In addition, we employed multivariate adaptive regression spline to detect inflection points for the nature of slope changes in cognitive decline among BD patients. During follow-up years, 21 BD patients (16.4%) showed longitudinal cognitive decline. In cognitive decline group, all cognitive domains of BAC-A were significantly worsened. We found that density of episodes with psychotic features was an independent risk factor for cognitive decline after adjusted for age, gender and dose of mood stabilizer. After the age of 42 years, a steeper cognitive change was observed in the cognitive decline group. The correlation pattern between cognitive domains and functional outcomes differed between patients with and without cognitive decline. The present study characterized cognitive heterogeneity longitudinally in BD patients. As density of episodes play roles for cognitive decline, our results emphasize the importance of relapse prevention. Our findings provide hints for future personalized interventions and facilitating genetic and biological studies for dissecting the heterogeneity of bipolar illness. We characterized the heterogeneity and risk factors of cognitive decline in euthymic bipolar disorder (BD), and their magnitude of associations with subjective daily functions. In this retrospective cohort, BD type I patients ( = 128) were followed for an average of 6.5 years. Intelligence quotient (IQ) at index date was recorded, and premorbid IQ was estimated. We used Brief Assessment of Cognition in Affective Disorders (BAC-A) to assess cognition at follow-up. We evaluated current functions with World Health Organization Disability Assessment Schedule 2.0. Clinical and sociodemographic factors were examined for their independent effects on longitudinal cognitive decline. In addition, we employed multivariate adaptive regression spline to detect inflection points for the nature of slope changes in cognitive decline among BD patients. During follow-up years, 21 BD patients (16.4%) showed longitudinal cognitive decline. In cognitive decline group, all cognitive domains of BAC-A were significantly worsened. We found that density of episodes with psychotic features was an independent risk factor for cognitive decline after adjusted for age, gender and dose of mood stabilizer. After the age of 42 years, a steeper cognitive change was observed in the cognitive decline group. The correlation pattern between cognitive domains and functional outcomes differed between patients with and without cognitive decline. The present study characterized cognitive heterogeneity longitudinally in BD patients. As density of episodes play roles for cognitive decline, our results emphasize the importance of relapse prevention. Our findings provide hints for future personalized interventions and facilitating genetic and biological studies for dissecting the heterogeneity of bipolar illness. |
| Author | Chang, Chiao-Erh Chen, Po-Yu Liu, Hsing-Cheng Kuo, Po-Hsiu Lin, Shih-Ku Huang, Ming-Chyi Lee, Ya-Chin Weng, Shih-Han Chen, Wen-Yin Chiu, Chih Chiang Kuo, Chian-Jue |
| AuthorAffiliation | 4 Department of Education and Research, Taipei City Hospital , Taipei , Taiwan 1 Department of Psychiatry, Taipei City Psychiatric Center, Taipei City Hospital , Taipei , Taiwan 6 Department of Psychiatry, National Taiwan University Hospital , Taipei , Taiwan 3 Department of Psychiatry, School of Medicine, College of Medicine, Taipei Medical University , Taipei , Taiwan 2 Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University , Taipei , Taiwan 5 Department of Public Health, College of Public Health, National Taiwan University , Taipei , Taiwan |
| AuthorAffiliation_xml | – name: 1 Department of Psychiatry, Taipei City Psychiatric Center, Taipei City Hospital , Taipei , Taiwan – name: 2 Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University , Taipei , Taiwan – name: 5 Department of Public Health, College of Public Health, National Taiwan University , Taipei , Taiwan – name: 6 Department of Psychiatry, National Taiwan University Hospital , Taipei , Taiwan – name: 4 Department of Education and Research, Taipei City Hospital , Taipei , Taiwan – name: 3 Department of Psychiatry, School of Medicine, College of Medicine, Taipei Medical University , Taipei , Taiwan |
| Author_xml | – sequence: 1 givenname: Wen-Yin surname: Chen fullname: Chen, Wen-Yin – sequence: 2 givenname: Ming-Chyi surname: Huang fullname: Huang, Ming-Chyi – sequence: 3 givenname: Ya-Chin surname: Lee fullname: Lee, Ya-Chin – sequence: 4 givenname: Chiao-Erh surname: Chang fullname: Chang, Chiao-Erh – sequence: 5 givenname: Shih-Ku surname: Lin fullname: Lin, Shih-Ku – sequence: 6 givenname: Chih Chiang surname: Chiu fullname: Chiu, Chih Chiang – sequence: 7 givenname: Hsing-Cheng surname: Liu fullname: Liu, Hsing-Cheng – sequence: 8 givenname: Chian-Jue surname: Kuo fullname: Kuo, Chian-Jue – sequence: 9 givenname: Shih-Han surname: Weng fullname: Weng, Shih-Han – sequence: 10 givenname: Po-Yu surname: Chen fullname: Chen, Po-Yu – sequence: 11 givenname: Po-Hsiu surname: Kuo fullname: Kuo, Po-Hsiu |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/34366918$$D View this record in MEDLINE/PubMed |
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| Cites_doi | 10.1097/NMD.0000000000000720 10.1111/j.1399-5618.2009.00739.x 10.1016/j.jad.2018.12.076 10.1016/j.jad.2014.12.028 10.1097/01.ALC.0000117832.62901.61 10.1002/ajmg.b.32581 10.1093/schbul/sbu198 10.1214/aos/1176347973 10.1017/S003329171700229X 10.1016/j.euroneuro.2016.04.002 10.5964/ejop.v12i4.909 10.1016/j.jad.2016.06.051 10.1016/j.jad.2007.02.008 10.1093/arclin/acw100 10.1016/j.neubiorev.2017.11.005 10.1111/acps.13144 10.1016/j.biopsych.2015.03.004 10.1007/s11920-015-0605-x 10.1111/bdi.12821 10.1016/j.schres.2015.09.017 10.1111/acps.12871 10.1016/j.jagp.2016.11.014 10.1093/ijnp/pyx032 10.1176/ajp.152.3.379 10.1093/schbul/sbv048 10.1111/bdi.12841 10.1097/YIC.0000000000000152 10.1097/NMD.0000000000000683 10.1016/j.neubiorev.2010.10.001 10.1111/j.1399-5618.2007.00469.x 10.1111/j.1399-5618.2006.00277.x 10.1111/bdi.12215 10.1177/1073191119831787 10.1111/bdi.12376 10.1111/acps.12133 10.1684/pnv.2019.0800 10.1111/j.1399-2406.2003.00059.x 10.1017/S0033291717001490 10.1007/s00406-015-0657-2 10.1016/j.jad.2014.04.028 10.1016/j.euroneuro.2014.09.007 10.1016/j.jad.2007.12.232 10.1017/S0033291712001614 10.4088/JCP.11m07471 10.2147/NDT.S100843 10.1111/bdi.12171 10.1111/bdi.12374 10.1017/S0033291718001885 10.7717/peerj.7432 10.6129/CJP.2008.5001.06 10.1016/j.schres.2018.08.013 10.1111/bdi.12907 10.1016/j.jad.2016.04.016 10.1111/j.1399-5618.2009.00698.x 10.1016/j.gaceta.2016.10.003 10.1016/j.jad.2013.04.028 10.1016/j.psychres.2017.04.058 10.1016/j.jpsychires.2014.10.002 10.1038/s41398-020-0718-9 10.1016/j.biopsych.2007.03.005 10.4088/JCP.v69n0504 |
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| Copyright | Copyright © 2021 Chen, Huang, Lee, Chang, Lin, Chiu, Liu, Kuo, Weng, Chen and Kuo. Copyright © 2021 Chen, Huang, Lee, Chang, Lin, Chiu, Liu, Kuo, Weng, Chen and Kuo. 2021 Chen, Huang, Lee, Chang, Lin, Chiu, Liu, Kuo, Weng, Chen and Kuo |
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| Keywords | BAC-A bipolar disorder longitudinal function assessment heterogeneity |
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| Notes | ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 Edited by: Danilo Arnone, United Arab Emirates University, United Arab Emirates This article was submitted to Mood and Anxiety Disorders, a section of the journal Frontiers in Psychiatry Reviewed by: Chien-Han Lai, National Yang-Ming University, Taiwan; Isabelle Esther Bauer, University of Texas Health Science Center at Houston, United States |
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| Title | The Heterogeneity of Longitudinal Cognitive Decline in Euthymic Bipolar I Disorder With Clinical Characteristics and Functional Outcomes |
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