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

From the Advanced Center for Intervention and Services Research for Late-Life Disorders, Department of Psychiatry, and the Bipolar Disorder Center for Pennsylvanians, University of Pittsburgh School of Medicine, Pittsburgh, PA (ACG, MAB, RKB, KS, MAD, CFR, DJK, BHM); the Mental Health Program, Center for Addiction and Mental Health and University of Toronto, Toronto, Canada (BHM); and the Department of Occupational Therapy, School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, PA (DC, JCR, MBH).

Objective: The authors report on the relationship between cognitive functioning and instrumental activities of daily living (IADLs) in elderly, clinically euthymic adults with bipolar disorder.

Methods: Twenty patients with bipolar disorder (age range: 61–86 years) were administered comprehensive neuropsychologic testing. Structured in-home performance-based assessments of IADLs were performed in 19 of these patients.

Results: Relative to age-equated comparators, bipolar subjects performed worse in information-processing speed and executive functioning. IADL performance was strongly correlated with these cognitive domains.

Conclusions: In euthymic elderly patients with bipolar disorder, decrements in information processing speed and executive functioning characterize cognitive function and are associated with poorer IADL performance.

Key Words: Bipolar disorder • elderly • cognition • IADLs

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