Early signs of accelerated cognitive decline in young patients with bipolar disorder imply neurodegeneration.

BACKGROUND

Bipolar disorder (BD) is a chronic mental illness characterized by high relapse rates and mood instability, which significantly impair neuropsychological functioning, sleep patterns, relationships, and occupational performance. This study explores the effects of accelerated aging on diverse domains of neuropsychological functions in adulthood BD patients.

METHODS

A total of 264 BD patients (ages 18-65) were recruited from both inpatient and outpatient settings, all in remission (Hamilton Depression Rating Scale [HDRS] ≤ 12; Young Mania Rating Scale [YMRS] ≤ 10). Additionally, 218 healthy controls (HCs) were included. All participants underwent a series of neuropsychological assessments, including the Wisconsin Card Sorting Test (WCST), Trail Making Test (TMT), Continuous Performance Test (CPT), and working memory tasks.

RESULTS

The results showed that BD patients exhibited overall deficits in neuropsychological performance compared to HC (ps < 0.0001), as expectedly. When divided into age groups (young and middle-to-old adulthood), young adulthood BD patients showed accelerated aging in cognitive domains, including psychomotor speed, impulsivity, and executive function, compared to the HC. The findings suggest an accelerated aging effect in BD patients, particularly in psychomotor, impulsivity, and cognitive flexibility.

CONCLUSIONS

These results highlight the importance of understanding the relationship between aging and neuropsychological decline in BD to improve treatment strategies and enhance patients' quality of life. The implications suggest that targeted interventions may consider age-related cognitive changes to optimize long-term outcomes for individuals with BD.