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PubMed1997

The cumulative effect of neglect and failure to thrive on cognitive functioning.

OBJECTIVE: A cumulative risk model was used to examine the relationship among neglect, failure to thrive (FTT), and cognitive functioning in low income children. METHOD: A sample of 177 children 3 to 30 months old was recruited from a pediatric clinic serving low-income, primarily African American families. Four groups were formed based on neglect and FTT status: Neglect and FTT, Neglect Only, FTT Only, and No Neglect or FTT. FTT was defined as weight-for-age below the 5th percentile on growth charts. To avoid the biases associated with Child Protective Service reports as definitions of neglect, the HOME scale (Caldwell & Bradley, 1984) was used to define neglect. RESULTS: The cognitive performance of the group with neglect and FTT was significantly below that of the children in the Neglect Only, FTT Only, and No Neglect or FTT groups. CONCLUSIONS: These findings support a model in which the accumulation of risk factors is detrimental to cognitive functioning. The results also underscore the need for thorough evaluation when one risk factor has been identified. Growth failure may come to the attention of medical personnel, but neglect may not be detected. However, a child experiencing both neglect and FTT may be at risk for significant deficits in cognitive functioning.

Child Abuse↗

PubMed2000

The association between low diastolic blood pressure in middle age and cognitive function in old age. A population-based study.

BACKGROUND: previous longitudinal studies have shown an inverse relation between blood pressure and cognitive function. OBJECTIVE: to determine the association between mid-life blood pressure and performance in different areas of cognitive function in late life. SUBJECTS AND METHODS: we recruited 502 men, aged 69-74 years, from a population-based cohort in Uppsala, Sweden. Blood pressure had been measured at age 50 and we examined performance in 13 psychometric tests about 20 years later. RESULTS: after the 39 men with a previous stroke had been excluded, there was an inverse relation between diastolic blood pressure at age 50 and performance 20 years later in the digit span test, the trail-making tests and in verbal fluency. The relationships were significant, independently of age, education and previous occupational level. Men within the lowest category of diastolic blood pressure (< or = 70 mmHg, n = 59) showed the best results. Baseline blood pressure levels were not linked to performance in tasks on vocabulary, verbal learning and memory or figure copying. CONCLUSIONS: low blood pressure in mid-life indicates a low long-term cerebrovascular risk and is associated with higher late-life performance in cognitive tests that mainly assess subcortico-frontal cognitive functions.

Aged↗

PubMed2003

Use of the internet and of the NHS direct telephone helpline for medical information by a cognitive function clinic population.

BACKGROUND: Internet websites and medical telephone helplines are relatively new and huge resources of medical information ("cybermedicine" and "telemedicine", respectively) accessible to the general public without prior recourse to a doctor. STUDY OBJECTIVES: To measure use of internet websites and of the NHS Direct telephone helpline as sources of medical information by patients and their families and/or carers attending a cognitive function clinic. DESIGN AND SETTING: Consecutive patients seen by one consultant neurologist over a six-month period in the Cognitive Function Clinic at the Walton Centre for Neurology and Neurosurgery, a regional neuroscience centre in Liverpool, UK. RESULTS: More than 50% of patients and families/carers had internet access; 27% had accessed relevant information, but none volunteered this. 82% expressed interest in, or willingness to access, websites with relevant medical information if these were suggested by the clinic doctor. Although 61% had heard of the NHS Direct telephone helpline, only 10% of all patients had used this service and few calls related to the reason for attendance at the Cognitive Function Clinic. CONCLUSIONS: Internet access and use is common in a cognitive function clinic population. Since information from internet websites may shape health beliefs and expectations of patients and families/carers, appropriately or inappropriately, it may be important for the clinic doctor to inquire about these searches. Since most would use websites suggested by the doctor, a readiness to provide addresses for appropriate sites may prove helpful.

Adult↗

PubMed2002

Does cognitive function improve with quetiapine in comparison to haloperidol?

Recent evidence suggests that schizophrenia patients taking atypical antipsychotic medications may perform better on some tests of cognitive function than those treated with older antipsychotics. The current study compared the effects of quetiapine and haloperidol on measures of executive function, memory and attention. Subjects were 58 stable outpatients with schizophrenia (DSM III-R) who received a battery of cognitive tests as part of a randomized, double-blind, multi-site clinical efficacy study conducted by AstraZeneca Pharmaceuticals. Cognitive assessments were conducted prior to randomization when patients were receiving < or =30 mg haloperidol or equivalent (mean: 9.2mg/day haloperidol equivalents), and again after 24 weeks of fixed-dose treatment with either quetiapine 600 or 300 mg/day or haloperidol 12 mg/day. Analyses of covariance with planned comparisons were used to compare scores on cognitive measures at the end of 24 weeks by treatment group with baseline cognitive function scores used as covariates. Patients receiving quetiapine 600 mg/day improved to a greater extent than patients receiving haloperidol on overall cognitive function (p<0.02). Specific differences were found for executive function (Verbal Fluency Test, p<0.04), attention (Stroop Color Word Test, p<.03) and verbal memory (Paragraph Recall Test, p<0.02). Treatment group differences were not solely due to benztropine use, medication side effects, or changes in symptomatology. Treatment with quetiapine at higher doses (600 mg/day) relative to haloperidol appears to have a positive impact on important domains of cognitive performance that have been found to predict role function and community outcomes in patients with schizophrenia.

Antipsychotic Agents↗

PubMed2003

Relation between cognitive function and mortality in middle-aged adults: the atherosclerosis risk in communities study.

An independent, inverse association between cognitive function and all-cause mortality has been reported in elderly cohorts. The purpose of this study was to determine whether the same association exists in middle-aged persons. The Atherosclerosis Risk in Communities Study is a cohort study initiated in 1987 to investigate the development of atherosclerosis in middle-aged persons. Three cognitive function measures were included in the second cohort examination conducted from 1990 to 1992 when the participants were aged 48-67 years: the Delayed Word Recall Test (DWRT), the Digit Symbol Substitution Test (DSST) (a subtest from the Wechsler Adult Intelligence Scale-Revised), and the Word Fluency Test from the Multilingual Aphasia Examination. Cox proportional hazards modeling was used to determine whether all-cause mortality ascertained through 1997 was associated with each measure after adjustment for sociodemographic, biologic, psychologic, and behavioral risk factors. Without adjustment, there was a significantly lower mortality hazard associated with higher scores on all three measures. After covariate adjustment, the hazard ratios for the DWRT and the DSST remained significant (hazard ratio1-point DWRT score increment = 0.90, 95% confidence interval: 0.84, 0.97; hazard ratio 7-point DSST score increment = 0.86, 95% confidence interval: 0.80, 0.93). Cognitive function measured in middle age appears to have prognostic importance for life expectancy similar to that reported in elderly adults.

Aged↗

PubMed1994

Cognitive functions in subjects with incidental cerebral hyperintensities.

We investigated the association between incidental cerebral hyperintensities (CH) found by magnetic resonance imaging (MRI) and cognitive functions in neurologically normal, nondemented subjects. Semiquantitative scores for MRI lesions and those for brain atrophy were compared with the results of extensive cognitive examinations using multivariate analysis. There was no correlation between CH and cognition, except that periventricular hyperintensities, especially those in posterior locations, were associated with reduced performance in the Stroop test. Overall cognitive functions were associated with age, and age was a predominant factor in the prefrontal functions. Brain atrophy was associated more with decline of the posterior and dorsolateral frontal brain functions. We suggest that disturbances in attention and speed may initially result from incidental CH, while other cognitive functions remain unaffected.

Adult↗

PubMed1992

Parasitic helminth infection and cognitive function in school children.

The study examines the effect of moderate to high worm burdens of Trichuris trichiura infection on the cognitive functions of 159 school children (age 9-12 years) in Jamaica, using a double-blind placebo-controlled protocol. Results were evaluated by using a forward-stepwise multiple linear regression. Removal of worms led to a significant improvement in tests of auditory short-term memory (p less than 0.017; p less than 0.013), and scanning and retrieval of long-term memory (p less than 0.001). Nine weeks after treatment, there were no longer significant differences between the treated children and an uninfected Control group in these three tests of cognitive function. It is concluded that whipworm infection has an adverse effect on certain cognitive functions which is reversible by therapy.

Albendazole↗

PubMed2006

Substance misuse and cognitive functioning in early psychosis: a 2 year follow-up.

High comorbidity exists between substance use and psychosis. Since substance use has been shown to negatively impact cognitive functioning in the general population, there is concern about the impact of substance use on already compromised cognitive functioning. However, the literature regarding the effects of substance use on cognition in early psychosis patients is inconclusive. The purpose of this study was to examine the relationship between substance misuse and cognitive functioning in a first episode psychosis sample for 2 years following admission to a specialized early psychosis program. One hundred and eighty-three subjects were assessed at baseline, 147 at 1 year and 116 at 2 years using the Case Manager Rating Scale (CMRS) for substance use and a comprehensive cognitive battery. Approximately 50% of subjects engaged in substance misuse at baseline, which did decrease over follow-up. At baseline, the cognitive performance of patients with both mild use and misuse was significantly better than non-users. These same patients demonstrated better performance at follow-up. These results do not provide evidence for a negative impact of substance use on cognition.

Adult↗

PubMed2006

[Cognitive function in patients with severe carotid stenosis--evaluation of RBANS, WAIS-R and NART before treatment of carotid revascularization--].

PURPOSE: To evaluate the cognitive function in preoperative patients with severe carotid stenosis. PATIENTS AND METHOD: Twenty-five patients with severe carotid stenosis were examined on their cognitive function by RBANS (Japanese version), WAIS-R (Japanese version), and NART (Japanese version) before treatment of carotid revascularization (endarterectomy or stenting). They had full activities of daily living without any hemiparesis, aphasia, agnosia, and apraxia at the time of the examinations. RESULTS: Mean intelligent quotient (IQ) measured by WAIS-R and NART was 104.0 +/- 10.7 and 101.3 +/- 13.4, (ns) respectively. Mean total scale of RBANS was 90.0 +/- 13.4, which was significantly lower than both the results of WAIS-R and NART. A mean value of each RBANS index was 91.3 +/- 11.7 in immediate memory, 102.0 +/- 18.2 in visuospatial/constructional, 93.2 +/- 8.7 in language, 84.6 +/- 14.7 in attention, and 92.1 +/- 14.4 in delayed memory. RBANS index significantly declined in immediate memory, language, attention and delayed memory than visuospatial/constructional. CONCLUSIONS: Qualitative evaluation was available in RBANS, WAIS-R, and NART, which enabled the investigators to make a precise comparison between these methods. WAIS-R and NART showed a comparatively preserved function and were presumed to be useful for the evaluation of the baseline of cognitive function in preoperative patients. RBANS demonstrated a slight decrease in memory and attention in those patients and was expected to be useful to detect the cognitive dysfunction when compared with WAIS-R and NART.

Activities of Daily Living↗

PubMed1991

Longitudinal application of cognitive function measures in a defined population of community-dwelling elders.

The nature and extent of possible age-related changes in cognitive function have primarily been examined in nonrandom samples, and have not been well described in population-based studies. We examined longitudinal changes in performance on a mental status examination and recall and recognition memory tests in a population-based (n = 1953) study of community-dwelling elders. Advanced age was associated with poorer performance on all tests and more rapid decline longitudinally on the mental status and recall and recognition memory tests. Less-educated persons performed more poorly. Lower levels of educational attainment were predictive of more rapid declines on the mental status examination and recall memory test among women. Subsequent survivorship was associated with preserved performance on the mental status and recall memory tests. These findings suggest that there are age-associated changes in cognitive function, and have implications for population-based studies of cognitive function and survey research in general.

Age Factors↗

PubMed1994

Improvement of cerebral blood flow and cognitive function following pacemaker implantation in patients with bradycardia.

We investigated the effects of pacemaker implantation on cerebral blood flow and cognitive function in 14 severely bradycardic patients (mean age 75.2 years). Cerebral blood flow and verbal intelligence improved after the pacemaker implantation. Systolic and mean arterial blood pressure was significantly reduced after the implantation. Changes in cerebral blood flow significantly correlated with changes in heart rate in polynomial regression analysis, but not with changes in cardiac output. Before the implantation, verbal cognitive function was lower in bradycardic patients than in age-matched control subjects, and brain CT showed significant advanced atrophy in these patients. However, verbal cognitive function was also improved after the implantation. Pacemaker implantation in the severe bradycardic elderly should be beneficial not only for cardiac function but also for brain function. We concluded that these results suggest that heart rate is one of the important factors in the regulation of cerebral circulation in patients with severe bradycardia. Pacemaker implantation in the elderly improved quality of life and may prevent mental deterioration.

Aged↗

PubMed2004

Randomized trial of the effects of simvastatin on cognitive functioning in hypercholesterolemic adults.

PURPOSE: In our initial study of the potential effects of cholesterol-lowering interventions on cognitive functioning, treatment with lovastatin as compared with placebo caused performance decrements on several neuropsychological tests, whereas scores on other tests were unaffected. The current study was designed to confirm and extend those findings. METHODS: The study comprised 308 hypercholesterolemic adults between 35 and 70 years of age. Employing a randomized double-blind design, we assigned participants to daily treatment with placebo, 10 mg of simvastatin, or 40 mg of simvastatin for 6 months. A neuropsychological test battery was administered to assess cognitive functioning at baseline and at the end of the treatment period. RESULTS: A total of 283 subjects completed the study: 94 subjects on placebo, 96 taking 10 mg of simvastatin, and 93 taking 40 mg of simvastatin. Compared with placebo, decremental effects of simvastatin treatment were found on tests previously observed to be sensitive to statins (P = 0.008; difference in summary z scores = 0.18; 95% confidence interval [CI]: 0.07 to 0.29) and on tests not previously administered (P = 0.04; difference in summary z scores = 0.17; 95% CI: 0.05 to 0.29), but not on tests previously observed to be insensitive to statins (P = 0.84; difference in summary z scores = 0.02; 95% CI: -0.07 to 0.10). For the three tests specifically affected by simvastatin, effects on cognitive performance were small, manifest only as failure to improve during the 6 months of treatment (compared with placebo), and were confounded by baseline differences on one test. CONCLUSION: This study provides partial support for minor decrements in cognitive functioning with statins. Whether such effects have any long-term sequelae or occur with other cholesterol-lowering interventions is not known.

Adult↗

PubMed1994

Nonresponse pattern and bias in a community-based cross-sectional study of cognitive functioning among the elderly.

The demographic, health, and mental functioning characteristics of nonresponders to a community-based cross-sectional study of cognitive functioning among the elderly in Amsterdam, the Netherlands (Amsterdam Study of the Elderly (AMSTEL), October 1990 to May 1991), were examined and compared with responders. The randomly selected age-stratified (65-74, 75-84 years) sample was drawn from nonresponders listed with a subsample (n = 8) of general practitioners whose lists served as the sampling frame for the main study. The general practitioners approached and interviewed the responding nonresponders using the same standardized questions that were used in the main study. Nonresponders (n = 115) and responders (n = 999) from the same medical practices were compared by means of chi-square and odds ratios. Compared with responders, these nonresponders more often reported a history of psychiatric illness, heart attack, stroke, and diabetes, and were more likely to be unmarried, to have a lower education, and to do poorly on the cognitive test (odds ratio = 1.6, 95% confidence interval 1.0-2.6). Most significant physical and mental health differences by response status were seen among the persons aged < 75 years and not among those aged > or = 75 years. The odds for poor cognitive test performance associated with age and stroke were relatively more biased than those associated with other risk factors. These results suggest that the characteristics of young-old and old-old elderly nonresponders to cross-sectional studies of cognitive function may differ, and that there may be selective nonresponse that could bias, to a different degree, estimates of risk for poor cognitive functioning. Studies should investigate the possibilities for nonresponse in their own setting.

Aged↗

PubMed2005

Assessment of cognitive function of the elderly population: effects of darifenacin.

PURPOSE: Overactive bladder is common in the elderly population, which is susceptible to cognitive disorders and drug induced cognitive impairment. Existing overactive bladder treatments may cause adverse events, such as cognitive impairment, due to antagonism of the M1 receptor in the central nervous system. In this study we evaluated the effect of darifenacin, an M3 selective antagonist, on cognitive function in elderly volunteers without clinical dementia. MATERIALS AND METHODS: This double-blind, 3-period crossover study randomized 129 volunteers 65 years or older with no/mild cognitive impairment to receive 3 of 5 treatments, namely darifenacin controlled release (3.75, 7.5 or 15 mg once daily), darifenacin immediate-release (5 mg 3 times daily) or matching placebo for 14 days. Each treatment period was separated by 7 days of washout. Cognitive function tests were completed at baseline and at treatment end. RESULTS: For the primary end points of memory scanning sensitivity, speed of choice reaction time and word recognition sensitivity, there were no statistically significant differences for darifenacin vs placebo. There were no statistically significant differences in secondary variables except memory scanning speed, which increased in all groups relative to baseline, but improvement was greater with placebo than with 3.75 mg darifenacin. Darifenacin treatment was not associated with changes in alertness, contentment or calmness, which are likely to be clinically relevant. Darifenacin was well tolerated. CONCLUSIONS: : In elderly volunteers 2 weeks of treatment with darifenacin had no effect on cognitive function compared with baseline and it was not significantly different from placebo. This may be related to its M3 receptor selectivity with negligible M1 receptor antagonism.

Aged↗

PubMed2005

Cognitive functions in severe congestive heart failure before and after an exercise training program.

BACKGROUND: Congestive heart failure is associated with cognitive impairment, particularly of attentional skills. We assessed, in a hypothesis-generating study, the effect of an exercise training program on cognitive functions among patients with severe congestive heart failure. METHODS: Patients with severe congestive heart failure (n=20; New York Heart Association functional class III; left ventricular ejection fraction < or =35%) were evaluated before and following a standardized and supervised exercise training program (x2/week for 18 weeks; exercise group), while 5 additional patients did not undergo an exercise training program (control group). A battery of cognitive tests was used to assess cognitive functions. Physical performance was assessed by the 6-min walk test and the modified Bruce exercise test, cardiac index and systemic vascular resistance using thoracic electrical bioimpedance, and cerebral vasomotor reactivity to hypercapnia by means of the breath-holding index using transcranial Doppler. RESULTS: Time of completion of the trail making A (105+/-116 to 75+/-52; p=0.02) and B (169+/-100 to 119+/-65; p=0.002) tests, and of the Stroop part A (40+/-13 to 37+/-13; p=0.04) was shorter in patients completing the exercise training program, but not in control patients, while the other neuropsychological measures remained unchanged in both groups. Cerebral vasomotor reactivity to hypercapnia remained diminished (breath-holding index 0.64+/-0.27 vs. 0.68+/-0.37) despite significant improvements in exercise capacity (6-min walk test 308+/-87 to 423+/-91 m, p<0.001; modified Bruce exercise test 5.6+/-3.8 to 9.8+/-3.4 min, p<0.001). CONCLUSIONS: Patients with severe congestive heart failure undergoing an exercise training program improve in some measures of cognitive functions that are limited to general attention and psychomotor speed. Based on these preliminary findings, further evaluations are designed within the framework of a larger controlled clinical trial.

Adult↗

PubMed2002

Hormone replacement therapy for cognitive function in postmenopausal women.

BACKGROUND: As estrogens have been found in animal models to be associated with the maintenance and protection of brain structures, it is biologically plausible that maintaining high levels of estrogens in postmenopausal women by medication could be protective against cognitive decline. OBJECTIVES: To investigate the effect of ERT (estrogens only) or HRT (estrogens combined with a progestagen) in comparison with placebo in randomized controlled trials (RCTs) on cognitive function in postmenopausal women. SEARCH STRATEGY: The CDCIG Specialized Register was searched using the terms ORT, PORT, ERT, HRT, estrogen*, oestrogen*, progesteron* on 16 May 2002. In addition MEDLINE (1966-2002/01); EMBASE (1985-2000/11); PsycINFO (1967-2002/01) and CINAHL (1982-2001/12) were searched as the CDCIG Register does not contain all trials with healthy volunteers. SELECTION CRITERIA: All double-blind randomized controlled trials of the effect of ERT or HRT on cognitive function over a treatment period of at least two weeks in postmenopausal women. DATA COLLECTION AND ANALYSIS: Abstracts of the references retrieved by the searches were read by two reviewers in order to discard those that were clearly not eligible for inclusion. The two reviewers studied the full text of the remaining references and independently selected studies for inclusion. Any disparity in the resulting lists was resolved by discussion with all reviewers in order to arrive at the final list of included studies. The selection criteria ensured that the blinding and randomization of the included studies was adequate. Two reviewers (EH and KY) assessed the quality of other aspects including design and assessment of outcomes. One reviewer (EH) extracted the data from the studies. MAIN RESULTS: In total, 15 trials involving 566 postmenopausal women were included, but 6 studies did not have adequate data for analysis. Meta-analyses showed a positive effect of 10 mg of estradiol (E2) bolus injections intramuscularly monthly in relatively young surgically menopausal women on the Paired Associate learning test immediate recall (z=2.40, p<0.05, chi-square test=1.12, p=0.29, SMD=1.02, 95% C.I.=0.19-1.85), on a test of abstract reasoning (z=10.45, p<0.0001, WMD=6.80, 95% C.I.=5.52-8.08) and a test of speed and accuracy (z=9.16, p<0.0001 WMD=6.00, 95% C.I.=4.72-7.28). However, most studies showed no evidence of an effect on verbal or visuospatial memory, mental rotations, speed or accuracy measures. There was little evidence that Premarin, the most widely prescribed estrogen for postmenopausal use, had positive effects on cognitive function. The one effect of 9 months of treatment with Premarin (and a progestagen) on a measure of complex speed of information processing (the TMT-B) was probably explained by baseline differences, as it was not reported by the authors. REVIEWER'S CONCLUSIONS: There was little evidence regarding the effect HRT or ERT on overall cognitive function in healthy postmenopausal women. There was an effect on some verbal memory functions (immediate recall), on a test of abstract reasoning and a test of speed and accuracy in relatively young (47 years of age) surgically menopausal women who had been given a bolus intramuscular injection of 10 mg E2 every month for 3 months. These effects were from small studies from a single research group. It remains to be determined whether factors such as an older age (> 69 years of age), type of menopause (surgical or natural) and type of treatment (E2 with or without a progestagen), mode of delivery (transdermal, oral or intramuscular), dosage and duration (> 3 months) could alter the effect on memory functions to a clinically relevant level. In addition, whether the absence or presence of menopausal symptoms can modify treatment effects should be investigated in more detail. Longitudinal RCTs currently underway in the U.S.A., U.K. and Canada will be able to test these hypotheses by the year 2010.

Cognition↗

PubMed1985

Experience-dependent recovery of cognitive functioning in young alcoholics.

Spontaneous recovery of some cognitive functioning in alcoholics after drinking has ceased has been convincingly demonstrated, but there have been no demonstrations of recovery that occurs primarily due to exposure of the alcoholic to specific environmental events. In the present study two groups of alcoholics began a 3-week series of tests sensitive to alcoholic cognitive dysfunction at different time lags after drinking ceased (1 week vs. at least 3 weeks). Each group received five administrations each of three tests. On two of the measures, comparisons between the initial testings administered at least three weeks apart revealed the expected pattern of improvement concommitant with the passage of time. On the Halstead-Reitan Trailmaking Test (Part B), initial test scores were equivalent, showing no time-dependent recovery. Instead, performance improved solely as a function of repeated task administration, thus demonstrating "experience-dependent" recovery. Initial levels of impairment and the extent of recovery were established using two non-alcoholic control groups. Since evidence has accrued that alcoholics' treatment outcome may relate to neuropsychological status, experience-dependent rehabilitation of cognitive functioning may improve success rates in alcoholism treatment.

Adult↗

PubMed2004

Cognitive function across manic or hypomanic, depressed, and euthymic states in bipolar disorder.

OBJECTIVE: The study aims were to address neuropsychological functioning across different states of bipolar illness and to determine relationships among clinical features, neuropsychological performance, and psychosocial functioning. METHOD: Several domains of cognitive function were examined in 30 depressed bipolar patients (DSM-IV criteria for major depression, Hamilton Depression Rating Scale score > or = 17), 34 manic or hypomanic bipolar patients (DSM-IV criteria for manic or hypomanic episode, Young Mania Rating Scale score > or = 12), and 44 euthymic bipolar patients (6 months of remission, Hamilton depression scale score < or = 8, and Young Mania Rating Scale score < or = 6). The comparison group consisted of 30 healthy subjects without history of neurological or psychiatric disorders. A neuropsychological battery assessed executive function, attention, and verbal and visual memory. RESULTS: The three groups showed cognitive dysfunction in verbal memory and frontal executive tasks in relation to the comparison group. Low neuropsychological performance was associated with poor functional outcome. Impairment of verbal memory was related to the duration of illness and the numbers of previous manic episodes, hospitalizations, and suicide attempts. CONCLUSIONS: A poorer performance was observed in all bipolar groups regarding executive function and verbal memory in relation to the healthy comparison subjects. These cognitive difficulties, especially related to verbal memory, may help explain the impairment regarding daily functioning, even during remission. Further studies should focus on testing, whether optimizing prophylactic pharmacological treatment and psychoeducation might reduce cognitive impairment, and whether bipolar patients would benefit from neuropsychological rehabilitation in order to reduce the impact of cognitive impairment in their overall functioning.

Adult↗