Self-reported cognitive complaints in elderly bipolar patients

BACKGROUND: Patients with bipolar disorder are at risk to develop cognitive decline in the course of their illness. This may affect their ability to monitor and detect their own cognitive functioning (anosognosia). The aim of this study was to determine whether subjective cognitive complaints were associated with objective neuropsychologic performance and to consider the role of frontal lobe dysfunction in the awareness of cognitive impairment. METHOD: A total of 101 euthymic elderly bipolar patients and 74 healthy comparison subjects were assessed using a comprehensive neuropsychologic battery. The Cognitive Failure Questionnaire was used to determine subjective cognitive complaints. RESULTS: Elderly bipolar patients had no more subjective cognitive complaints than comparison subjects, whereas they showed less cognitive functioning in several domains. Having few subjective cognitive complaints was associated with poorer attentional and executive functioning. CONCLUSIONS: Impaired awareness of cognition might be a reflection of cognitive deterioration and could influence treatment. Evaluation of cognitive functioning in elderly bipolar patients should be part of the treatment program regardless of subjective complaints. © 2012 American Association for Geriatric Psychiatry.