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Allostatic load but not medical burden predicts memory performance in late‐life bipolar disorder
Author(s) -
Vaccarino Sophie R.,
Rajji Tarek K.,
Gildengers Ariel G.,
Waters Sarah E.S.,
Butters Meryl A.,
Me Mahesh,
Blumberger Daniel M.,
Voineskos Aristotle N.,
Miranda Dielle,
Mulsant Benoit H.
Publication year - 2018
Publication title -
international journal of geriatric psychiatry
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.28
H-Index - 129
eISSN - 1099-1166
pISSN - 0885-6230
DOI - 10.1002/gps.4829
Subject(s) - allostatic load , allostasis , psychology , cognition , effects of sleep deprivation on cognitive performance , neuropsychology , mood , population , cognitive skill , clinical psychology , gerontology , psychiatry , medicine , environmental health , neuroscience
Objective Older patients with bipolar disorder (BD) present with variable degrees of cognitive impairment. Over time, stress, mood episodes, and comorbidities increase the body's allostatic load. We assessed the extent to which allostatic load vs more traditional measures of medical burden account for the heterogeneity in cognition in this population. Methods Thirty‐five older euthymic patients with BD and 30 age‐equated, gender‐equated, and education‐equated comparison participants were administered a comprehensive assessment including a neuropsychological battery, and 9 physiological measures to determine allostatic load. The relationship among allostatic load, medical burden, and cognition was assessed. Results Compared with the mentally healthy comparators, patients were impaired globally, and in 4 cognitive domains—information‐processing speed / executive functioning, delayed memory, language, and visuomotor ability, and presented with greater medical burden but not a different allostatic load. Allostatic load, but not medical burden, was associated with delayed memory performance both in a correlational analysis and in a multivariate regression analysis. Conclusion Euthymic older patients with BD are impaired on several cognitive domains and have high medical burden. Their memory performance is more strongly associated with allostatic load than with traditional measures of medical burden. These findings need to be replicated and extended longitudinally.