Schizophrenia cognition tool promising in bipolar disorder patients

By Eleanor McDermid, Senior medwireNews Reporter

The Brief Assessment of Cognition in Schizophrenia (BACS) may be an appropriate tool for measuring cognition in elderly patients with bipolar disorder, a pilot study suggests.

There is currently no simple and reliable scale that is specific to this subgroup, say lead researcher Jennyfer Cholet (Université de Nantes, France) and co-workers.

But they say that the BACS fulfills almost all of the specifications for assessing cognition laid down by the International Society for Bipolar Disorders (ISBD) Cognition Committee, in that it measures psychomotor speed, executive functions, attention, verbal memory, and working memory.

The team recruited 42 bipolar disorder patients, aged an average of 70 years, to undergo neurocognitive assessment. Their scores on the BACS significantly and positively correlated with their scores on a standard battery of tests, and their scores on the BACS subscales correlated with their scores on the corresponding standard tests for the same domains.

Furthermore, BACS scores correlated with patients’ scores on scales measuring their global functioning and activities of daily living.

“Thus, our results revealed that the BACS is a useful and promising tool for the assessment of cognitive functioning in elderly patients with [bipolar disorder],” write the researchers in Bipolar Disorders.

The only recommended item not assessed by the BACS is visual memory. However, Cholet et al found that BACS scores correlated with visual memory scores in the standard tests.

“This finding raises important questions concerning the role and importance of visual memory in executive functions,” they say. “Thus, the relevance of adding a test of visual memory for elderly patients with [bipolar disorder] may be questionable.”

Fifteen patients with schizophrenia, aged an average of 69 years, also completed the neurocognitive assessment. The bipolar disorder patients tended to score more highly on the BACS than these schizophrenia patients, significantly so for global scores and for the List Learning and Token Motor Task subscores. This placed their cognitive function in between that of schizophrenia patients and the normative BACS data.

Given these findings, and that it can be completed in less than 35 minutes, “the BACS could effectively be integrated into a psychiatric follow-up consultation,” conclude the researchers.

“These results are promising and merit replication in a larger sample to better explore the impact of potential confounding factors,” they add.

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