Rapid Cycling and lower hemoglobin in elderly bipolar patients with brain atrophy

Research output: Contribution to journalArticle

Abstract

Purpose: Bipolar disorder, medical comorbidity, and aging effects increase the risk for cognitive impairment in patients with bipolar disorder. In addition, brain atrophy in late life plays an important role in cognitive dysfunction. We attempted to find out the specific clinical characteristics that may identify patients with bipolar disorder at high risk for developing brain atrophy later in life. Methods: We recruited bipolar I patients (Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition) without concurrent dementia who were older than 60 years and had at least one psychiatric admission. Patients were divided into two groups based on the presence or absence of brain atrophy determined by structural magnetic resonance imaging at 1.5 T. Clinical data of bipolar illness-related features and general medical laboratory results were obtained by reviewing medical records and interviewing patients and family members. Results: There were 44 elderly patients with bipolar disorder in this study; 33 of them (75%) had cortical or subcortical brain atrophy. Multivariate analysis showed that, after adjusting for current age, significant predictive validity for brain atrophy was provided by a positive history of rapid cycling with adjusted odds ratio of 11.85 (95% confidence interval [CI] for odds ratio [OR]=1.21-116.57) or lower hemoglobin levels during affective episodes (adjusted odds ratio 0.44, 95% CI for OR=0.21-0.92). Conclusion: Elder patients with bipolar disorder and a history of rapid cycling and lower hemoglobin levels during acute affective episodes may have increased risk for developing brain atrophy later in life.

Original languageEnglish
Pages (from-to)101-103
Number of pages3
JournalJournal of Experimental and Clinical Medicine(Taiwan)
Volume5
Issue number3
DOIs
Publication statusPublished - 2013

Fingerprint

Atrophy
Hemoglobins
Bipolar Disorder
Brain
Odds Ratio
Confidence Intervals
Diagnostic and Statistical Manual of Mental Disorders
Medical Records
Psychiatry
Dementia
Comorbidity
Multivariate Analysis
Magnetic Resonance Imaging

Keywords

  • Brain atrophy
  • Elderly
  • Hemoglobin
  • Rapid cycling bipolar disorder

ASJC Scopus subject areas

  • Medicine(all)

Cite this

@article{839c82093bee4dba9986797947e264e6,
title = "Rapid Cycling and lower hemoglobin in elderly bipolar patients with brain atrophy",
abstract = "Purpose: Bipolar disorder, medical comorbidity, and aging effects increase the risk for cognitive impairment in patients with bipolar disorder. In addition, brain atrophy in late life plays an important role in cognitive dysfunction. We attempted to find out the specific clinical characteristics that may identify patients with bipolar disorder at high risk for developing brain atrophy later in life. Methods: We recruited bipolar I patients (Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition) without concurrent dementia who were older than 60 years and had at least one psychiatric admission. Patients were divided into two groups based on the presence or absence of brain atrophy determined by structural magnetic resonance imaging at 1.5 T. Clinical data of bipolar illness-related features and general medical laboratory results were obtained by reviewing medical records and interviewing patients and family members. Results: There were 44 elderly patients with bipolar disorder in this study; 33 of them (75{\%}) had cortical or subcortical brain atrophy. Multivariate analysis showed that, after adjusting for current age, significant predictive validity for brain atrophy was provided by a positive history of rapid cycling with adjusted odds ratio of 11.85 (95{\%} confidence interval [CI] for odds ratio [OR]=1.21-116.57) or lower hemoglobin levels during affective episodes (adjusted odds ratio 0.44, 95{\%} CI for OR=0.21-0.92). Conclusion: Elder patients with bipolar disorder and a history of rapid cycling and lower hemoglobin levels during acute affective episodes may have increased risk for developing brain atrophy later in life.",
keywords = "Brain atrophy, Elderly, Hemoglobin, Rapid cycling bipolar disorder",
author = "Chen, {Pao Huan} and Tsai, {Shang Ying} and Rong-Long Shiu and Lin, {Hui Wen} and Shou-Hung Huang and Chung, {Kuo Hsuan}",
year = "2013",
doi = "10.1016/j.jecm.2013.04.004",
language = "English",
volume = "5",
pages = "101--103",
journal = "Journal of Experimental and Clinical Medicine",
issn = "1878-3317",
publisher = "Elsevier Taiwan LLC",
number = "3",

}

TY - JOUR

T1 - Rapid Cycling and lower hemoglobin in elderly bipolar patients with brain atrophy

AU - Chen, Pao Huan

AU - Tsai, Shang Ying

AU - Shiu, Rong-Long

AU - Lin, Hui Wen

AU - Huang, Shou-Hung

AU - Chung, Kuo Hsuan

PY - 2013

Y1 - 2013

N2 - Purpose: Bipolar disorder, medical comorbidity, and aging effects increase the risk for cognitive impairment in patients with bipolar disorder. In addition, brain atrophy in late life plays an important role in cognitive dysfunction. We attempted to find out the specific clinical characteristics that may identify patients with bipolar disorder at high risk for developing brain atrophy later in life. Methods: We recruited bipolar I patients (Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition) without concurrent dementia who were older than 60 years and had at least one psychiatric admission. Patients were divided into two groups based on the presence or absence of brain atrophy determined by structural magnetic resonance imaging at 1.5 T. Clinical data of bipolar illness-related features and general medical laboratory results were obtained by reviewing medical records and interviewing patients and family members. Results: There were 44 elderly patients with bipolar disorder in this study; 33 of them (75%) had cortical or subcortical brain atrophy. Multivariate analysis showed that, after adjusting for current age, significant predictive validity for brain atrophy was provided by a positive history of rapid cycling with adjusted odds ratio of 11.85 (95% confidence interval [CI] for odds ratio [OR]=1.21-116.57) or lower hemoglobin levels during affective episodes (adjusted odds ratio 0.44, 95% CI for OR=0.21-0.92). Conclusion: Elder patients with bipolar disorder and a history of rapid cycling and lower hemoglobin levels during acute affective episodes may have increased risk for developing brain atrophy later in life.

AB - Purpose: Bipolar disorder, medical comorbidity, and aging effects increase the risk for cognitive impairment in patients with bipolar disorder. In addition, brain atrophy in late life plays an important role in cognitive dysfunction. We attempted to find out the specific clinical characteristics that may identify patients with bipolar disorder at high risk for developing brain atrophy later in life. Methods: We recruited bipolar I patients (Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition) without concurrent dementia who were older than 60 years and had at least one psychiatric admission. Patients were divided into two groups based on the presence or absence of brain atrophy determined by structural magnetic resonance imaging at 1.5 T. Clinical data of bipolar illness-related features and general medical laboratory results were obtained by reviewing medical records and interviewing patients and family members. Results: There were 44 elderly patients with bipolar disorder in this study; 33 of them (75%) had cortical or subcortical brain atrophy. Multivariate analysis showed that, after adjusting for current age, significant predictive validity for brain atrophy was provided by a positive history of rapid cycling with adjusted odds ratio of 11.85 (95% confidence interval [CI] for odds ratio [OR]=1.21-116.57) or lower hemoglobin levels during affective episodes (adjusted odds ratio 0.44, 95% CI for OR=0.21-0.92). Conclusion: Elder patients with bipolar disorder and a history of rapid cycling and lower hemoglobin levels during acute affective episodes may have increased risk for developing brain atrophy later in life.

KW - Brain atrophy

KW - Elderly

KW - Hemoglobin

KW - Rapid cycling bipolar disorder

UR - http://www.scopus.com/inward/record.url?scp=84879554464&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84879554464&partnerID=8YFLogxK

U2 - 10.1016/j.jecm.2013.04.004

DO - 10.1016/j.jecm.2013.04.004

M3 - Article

AN - SCOPUS:84879554464

VL - 5

SP - 101

EP - 103

JO - Journal of Experimental and Clinical Medicine

JF - Journal of Experimental and Clinical Medicine

SN - 1878-3317

IS - 3

ER -