The double burden of age and disease on cognition and quality of life in bipolar disorder

Objective Bipolar disorder (BPD) and normal aging are known to impact cognitive skills and health-related quality of life (HRQOL). This study investigated how aging and disease interact in predicting cognitive and psychosocial outcomes. Methods Eight cognitive and ten subjective HRQOL domain ratings were measured. Subjects included 80 young (18-29 years) and late middle-aged (50-65 years) BPD patients in the euthymic phase and 70 age-equivalent healthy comparison participants. Results An age X disease interaction was detected in three domains of cognitive functioning that reflect emotion processing, processing speed, and executive functioning skills, with BPD patients in the older group performing most poorly. There was a double burden of aging and disease on reported ability to perform physical tasks. However, regardless of age, disease status was associated with lower ratings of HRQOL in the psychosocial/affective sphere and the majority of cognitive domains. Post hoc analyses revealed that number of years ill was positively associated with select HRQOL ratings in older, but not younger BPD adults. Conclusions These findings may stimulate future longitudinal study of cognition and quality of life in BPD patients across the life span, focusing on additive and interactive effects of aging and disease burden, which could culminate in developing more effective treatment and rehabilitation strategies for this traditionally challenging to treat population.