Older adults with major depressive disorder (MDD) and bipolar disorder (BP) have a greater medical burden outside of these illnesses when it comes to neurophysical deficits and cognitive function, researchers said here on March 7 at the 2010 Annual Meeting of the American Association for Geriatric Psychiatry (AAGP).
This may result in less effective treatment of all associated conditions and may impact functional outcomes for geriatric patients with mood disorders, the researchers said.
Brittany L. Jordan Geriatric Psychiatry Research Program, McLean Hospital, Belmont, Maryland, and colleagues recruited 97 patients from a mood disorders research program at McLean Hospital.
Mean age was 68.9 years and 48.5% were female. Of the patients, 43 were diagnosed with MDD, 32 with BP, and 30 were considered to be healthy controls.
Clinical and cognitive data were obtained during initial study visits.
Patients were administered a battery of neurocognitive, mood and symptom measures, along with the Cumulative Illness Rating Scale-Geriatric (CIRS-G). Linear regression was then used to test for associations between diagnosis and medical comorbidity, and between medical burden and neuropsychological deficits in patients and control participants.
The control group performed better than the MDD or BP groups on measures of executive functioning.
When the results were analysed, a significant association between diagnosis and CIRS-G total score was found. Patients with MDD or BP had higher CIRS-G scores than the controls.
From these results, MDD and BP were determined to impact comorbidity in patients with these mood disorders.
“Since mood disorders and medical comorbidities are associated with cognitive defects and poor functional outcomes, a more integrated treatment model may be indicated,” said Jordan.
The team recommends further research to determine the nature of this relationship and its impact on outcomes to better address the burden faced by the elderly and the broader public health implications related to institutionalisation, isolation, and healthcare resource utilisation.
The research was funded by the Rogers Family Foundation, NARSAD, GlaxoSmithKline, and Pfizer.
[Presentation title: Medical Comorbidity and Cognition in Geriatric Patients With Bipolar Disorder and Major Depressive Disorder. Abstract EI26]
By Carole VanSickle Ellis