scholarly journals A 12‐week open‐label pilot study of donepezil for cognitive functioning and instrumental activities of daily living in late‐life bipolar disorder

2008 ◽  
Vol 23 (7) ◽  
pp. 693-698 ◽  
Author(s):  
Ariel G. Gildengers ◽  
Meryl A. Butters ◽  
Denise Chisholm ◽  
Charles F. Reynolds ◽  
Benoit H. Mulsant
Keyword(s):  
Bipolar Disorder ◽  
Pilot Study ◽  
Activities Of Daily Living ◽  
Cognitive Functioning ◽  
Daily Living ◽  
Late Life ◽  
Open Label ◽  
Instrumental Activities

Cognitive Functioning and Instrumental Activities of Daily Living in Late-Life Bipolar Disorder

2007 ◽  
Vol 15 (2) ◽  
pp. 174-179 ◽  
Author(s):  
Ariel G. Gildengers ◽  
Meryl A. Butters ◽  
Denise Chisholm ◽  
Joan C. Rogers ◽  
Margo B. Holm ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Activities Of Daily Living ◽  
Cognitive Functioning ◽  
Daily Living ◽  
Late Life ◽  
Instrumental Activities

scholarly journals Two-year course of cognitive function and instrumental activities of daily living in older adults with bipolar disorder: evidence for neuroprogression?

2012 ◽  
Vol 43 (4) ◽  
pp. 801-811 ◽  
Author(s):  
A. G. Gildengers ◽  
D. Chisholm ◽  
M. A. Butters ◽  
S. J. Anderson ◽  
A. Begley ◽  
...  
Keyword(s):  
Older Adults ◽  
Bipolar Disorder ◽  
Cognitive Impairment ◽  
Cognitive Function ◽  
Activities Of Daily Living ◽  
Cognitive Aging ◽  
Repeated Measures ◽  
Daily Living ◽  
Time Points ◽  
Instrumental Activities

BackgroundWhile bipolar disorder (BD) is a leading cause of disability, and an important contributor to disability in BD is cognitive impairment, there is little systematic research on the longitudinal course of cognitive function and instrumental activities of daily living (IADLs) in late-life. In this report, we characterize the 2-year course of cognitive function and IADLs in older adults with BD.MethodWe recruited non-demented individuals 50 years and older with BD I or BD II (n = 47) from out-patient clinics or treatment studies at the University of Pittsburgh. Comparator subjects (‘controls’) were 22 individuals of comparable age and education with no psychiatric or neurologic history, but similar levels of cardiovascular disease. We assessed cognitive function and IADLs at baseline, 1- and 2-year time-points. The neuropsychological evaluation comprised 21 well-established and validated tests assessing multiple cognitive domains. We assessed IADLs using a criterion-referenced, performance-based instrument. We employed repeated-measures mixed-effects linear models to examine trajectory of cognitive function. We employed non-parametric tests for analysis of IADLs.ResultsThe BD group displayed worse cognitive function in all domains and worse IADL performance than the comparator group at baseline and over follow-up. Global cognitive function and IADLs were correlated at all time-points. The BD group did not exhibit accelerated cognitive decline over 2 years.ConclusionsOver 2 years, cognitive impairment and associated functional disability of older adults with BD appear to be due to long-standing neuroprogressive processes compounded by normal cognitive aging rather than accelerated cognitive loss in old age.

scholarly journals Latent Classes of First Incident Difficulty in Instrumental Activities of Daily Living

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 1045-1045
Author(s):  
Danielle Feger ◽  
Jennifer Deal ◽  
Alden Gross
Keyword(s):  
Activities Of Daily Living ◽  
Cognitive Functioning ◽  
Daily Living ◽  
Task Difficulty ◽  
Latent Class ◽  
Latent Class Models ◽  
Everyday Functioning ◽  
Class Differences ◽  
Instrumental Activities ◽  
Parsimonious Model

Abstract Ability to perform instrumental activities of daily living (IADLs) deteriorates during prodromal Alzheimer’s disease (AD), eventually leading to impaired everyday functioning and dementia. Ordering and timing of IADL difficulty onset may identify individuals at greater risk of cognitive impairment, but most studies only consider total number of difficult tasks. Leveraging longitudinal data from the Advanced Cognitive Training in Independent and Vital Elderly (ACTIVE) Study who entered free of any IADL difficulty (N=1266), we hypothesized that a latent class analysis based on timing of first reported IADL task difficulty would reveal class differences in cognitive functioning . Participants were followed until they self-reported at least one IADL difficulty, study completion (10 years), or loss to follow-up. Discrete-time multiple event process survival mixture (MEPSUM) models were used to simultaneously estimate hazards of incident IADL task difficulty across 7 task groups. Two, 3, 4, and 5 latent class models were fit to the data. Both unadjusted and covariate-adjusted models (adjusted for age, sex, race, education, marital status, and general health rating) were fit. Using the 2-class solution as the most parsimonious model, model entropy was 0.855. The model was able to distinguish a class of participants with lower global cognitive factor scores at baseline (Cohen’s D = 0.23, P = 0.04). We conclude that first incident IADL difficulty may be a useful measure in identifying individuals with worse cognitive functioning.

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