Bipolar blogger Natasha Tracy offers exclusive insight into the world of bipolar disorder.See all posts »
Does Having Bipolar Increase Your Risk of Dementia?
Recently I went to see my father. My father is in full-blown dementia and lives in a geriatric psychiatric wing of a hospital. He is 67. (For your reference, the current life expectancy of a man is 80.) He has been dealing with this since, perhaps, the age of 60; it’s hard to say. At this point he doesn’t recognize anyone, he’s non-verbal, he can barely walk, he’s tremendously stooped over and he seems constantly distressed.
It was, without a doubt, one of the most disturbing things I have ever witnessed.
My father was also diagnosed with bipolar disorder when he was younger. He remained untreated his entire life and chose to self-medicate with alcohol. However, currently, the bipolar is a non-issue compared with his symptoms of dementia.
Seeing him like that begs the question, do people with bipolar disorder have a higher risk of developing dementia?
Cognitive Deficits and Bipolar Disorder
It’s fairly well known that bipolar has negative effects on the brain such as decreasing brain volume in some areas (particularly when untreated). Moreover, cognitive deficits are also fairly well documented in bipolar disorder. Cognitive deficits typically include problems with executive function, memory, sustained attention and processing speed. Even euthymic patients present cognitive deficits.
But do these cognitive deficits worsen with age and does bipolar disorder lead to dementia?
Do Cognitive Deficits Worsen with Age?
This part of the question we can’t seem to answer yet. The question as to whether these cognitive deficits worsen with age seems to be unknown at this time. It wouldn’t surprise me if they did, but I don’t see any clinical evidence stating it at the moment.
Does Bipolar Lead to Dementia?
On this part I have bad news, it seems that studies have found that people with bipolar disorder have a significantly increased risk of dementia and worse yet, they seem to develop it earlier. According to this study, people with bipolar disorder tend to develop dementia in “middle age.” In one study, among older bipolar patients, 19 percent had dementia.
Is there Any Good News?
I know this seems like really bad news—and it is—but there is one bit of good news: lithium seems to have a neuroprotective effect. Those that have taken long-term lithium have been shown to have a decreased risk of dementia than those who have not (the risk returned to that of the general population). Similarly, there is a lower risk of Alzheimer’s in those that have taken long-term lithium.
In one study, Alzheimer’s disease risk was cut down from 33 percent to 5 percent (the general population risk) in those who had received continuous lithium. Whether other medications have a neuroprotective effect is not yet known.
I know that the “good news” doesn’t seem all that good, and it’s not, really. But maybe we can be hopeful that the more successfully bipolar is treated, the better our chances are of not being at greater risk for dementia and Alzheimer’s disease.
And bipolar disorder is being more successfully treated every day.
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