Document Type
Article
Publication Date
12-7-2025
Abstract
Objectives Executive function deficits in bipolar disorder (BD) are major contributors to disability in older age BD (OABD). We investigated the difference between OABD and age-equated healthy comparators (HC); and, in the OABD group, the associations of executive function with age, symptom severity, global cognition, and daily functioning. Design Cross-sectional analysis of executive function in OABD versus HC. Setting Analysis of large archival dataset harmonized from 12 international OABD studies. Participants Older adults (≥50 years) with OABD ( n = 614) and HC ( n = 192). Measurements Executive function was assessed via Trail Making Test B (TMT-B) completion time; covariates included age, self-reported gender, education, study site, medications (antipsychotics, lithium), and psychomotor speed. Results Executive function was worse in OABD than in HC, even after controlling for psychomotor speed (p < 0.001). In the OABD group, test completion was associated with less severe manic symptoms (p < 0.001). Worse executive function was associated with older age (p = 0.001), antipsychotic use (p < 0.001), worse global cognition (p < 0.001), and worse daily functioning (p < 0.001). Conclusions Executive dysfunction is a prominent feature of OABD, associated with several demographic and clinical characteristics. Future longitudinal studies of executive function and OABD need to assess the individual impact of impairment in executive function on everyday functioning to inform personalized interventions targeting specific patient subgroups.
Keywords
bipolar disorder, executive function, functioning, older adults
Language
English
Publication Title
American Journal of Geriatric Psychiatry
Rights
© 2025 The Author(s). This is an Open Access work distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.
Recommended Citation
Klaus, F., Appiah, E., Barbosa, I. G., Chen, P., Gildengers, A., Nunes, P. V., ... & Eyler, L. T. (2025). Executive function among older adults with bipolar disorder: a GAGE-BD analysis. The American Journal of Geriatric Psychiatry. https://doi.org/10.1016/j.jagp.2025.11.017
Manuscript Version
Final Publisher Version