Steeper aging-related declines in cognitive control processes among adults with bipolar disorders

Adriana Seelye, Paul Thuras, Bridget Doane, Christie Clason, Wendy VanVoorst, Snežana Urošević

Research output: Contribution to journalArticlepeer-review

17 Scopus citations


Background: Little is known about the specificity of executive functioning (EF) decline in older adults with bipolar disorders (OABD), or the impact of bipolar disorders (BD) on the timing and slope of age-related declines in EF processes implicated in both BD etiology and normative aging—cognitive control (CC). This cross-sectional study investigated age-related CC decline in BD. Methods: Participants were 43 adults with BD (M age = 61.5, SD = 15.8; 86% male) and 45 Controls (M age = 65.2, SD = 12.2; 98% male). Two-way ANOVAs examined the effects of median-age-split and diagnostic groups on cognitive processes with established BD deficits–CC processes (mental flexibility and response inhibition), verbal learning, and verbal fluency. Results: The median-split-age-by-diagnostic-group interaction was significant for mental flexibility; OABD performed significantly worse than younger adults with BD and younger and older Controls. Exploratory multivariate adaptive regression spline characterized non-linear nature of aging-slope changes in mental flexibility for each diagnostic group, yielding an inflection point at older age and steeper subsequent decline in OABD versus Controls. Limitations: This study is limited by a small sample (particularly for select neuropsychological measures) of mostly Caucasian men and BD diagnoses based on clinical interview and medical records review. Conclusions: Compared to healthy older adults, OABD showed steeper age-related decline in mental flexibility—select EF processes that depend on the integrity of the CC system. Preliminary evidence links CC integrity to daily functioning in OABD; accelerated aging decline in CC may pose a mechanism for high risk of functional impairment and dementia in OABD.

Original languageEnglish (US)
Pages (from-to)595-602
Number of pages8
JournalJournal of Affective Disorders
StatePublished - Mar 1 2019

Bibliographical note

Funding Information:
The authors’ work on this article was supported by the Minneapolis VA Health Care System. The contents do not represent the views of the US Department of Veteran Affairs or the US Government. This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Publisher Copyright:
© 2018

Copyright 2019 Elsevier B.V., All rights reserved.


  • Aging
  • Bipolar disorders
  • Cognitive control
  • Neuropsychological tests


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