I recently got a call from an aging family member who has suffered with bipolar disorder, untreated for most of his life. He explained to me about the police cars that had “surrounded” his home and were “monitoring” him, but really were trying to harm him because they were involved in a “conspiracy with the gangsters who live down the street.”
I sighed. This was just another in a long line of these kinds of episodes, and I was pretty sure it would resolve on its own with my relative hunkering down in his house for a while until he was sure the police had gone away.
But then I decided to go see him as soon as I could, because he just turned 80 and I began to wonder if I should be worried that in addition to his bipolar disorder he might not be showing some signs of dementia. I wasn’t sure about the overlap between bipolar and dementia. We know from studies that people with bipolar disorder often have cognitive problems – memory, executive function, and other thinking problems. But does this put them at higher risk for memory problems in old age?
My visit with my relative was, thankfully, uneventful. He was physically fit and taking care of himself as well as he usually does. His rants and wild conversations were about the same as always. The police issue had subsided, as I had expected it would. But I was still curious about this connection between bipolar and dementia.
Unfortunately, the research is limited. An article from the journal Psychogeriatrics, by Masouy et al, published in March 2011, suggests that long-term studies are needed to determine the course of cognitive impairments in bipolar disorder – to see if they are stable or more likely to progress with age. But there are few studies to date that look at this at all.
Another study from the British Journal of Psychiatry in May 2011, by Young, mentions studies suggesting that lithium may be protective against dementia. He says that Alzheimer’s rates are relatively reduced in bipolar patients taking lithium. A study looking specifically at lithium showed that lithium seemed to reduce progression of minimal cognitive impairment. (This seems kind of counter-intuitive to me, because lithium often creates a sensation of cognitive clouding in people who take it, but it at least one study has found that lithium increases brain volume in the hippocampus – a brain region that is very important in mood and emotions. See my previous post, “Lithium Increased Brain Volume in Patients with Bipolar Disorder.”)
This seems to be an area with little research and less understanding, but one that will become more important as more and more people with bipolar disorder live into older years.