Cognitive dysfunction is a core trait of bipolar disorder, and long-held views linked manic episodes to progressive brain structural changes and later dementia. Evidence from people who have never had symptoms but carry genetic risk for bipolar disorder suggests brain changes can appear without manic episodes. Dementia risk is higher among people with bipolar disorder, but other influences such as childhood trauma may contribute. Lifestyle choices and treatments can protect cognitive health, prevent episodes, and reduce dementia risk. Overall, shared vulnerabilities and modifiable factors may better explain the relationship than direct episode-to-dementia causation.
"It was long believed that manic episodes straightforwardly caused structural and cognitive brain changes. Evidence of these changes in never-symptomatic people with genetic risk for bipolar calls that into question. Dementia risk is higher in people with bipolar but may be due to other factors like childhood trauma. Certain lifestyle choices and treatments protect cognitive health, prevent episodes, and reduce dementia risk."
"Cognitive dysfunction is a core trait of bipolar disorder. That's a short assertion bursting at the seams with nuance and caveat. For starters, what causes this core trait? The consensus had been that manic episodes progressively damage the brain, causing cognitive dysfunction, and eventually leading to dementia for some. Now we're not so sure."
"Josie is a 25-year-old single mother and a participant in a longitudinal research study on cortical thickness changes in the brains of people with genetic risk for bipolar diagnosis. (Cortical thinning is one of several brain changes seen in bipolar disorder and is generally associated with cognitive impairment.) Josie's father had bipolar disorder, and while he was often supportive and loving, he also struggled with addiction and bouts of explosive anger. Genetically, she carries a baseline 5-10% risk of developing clinical bipolar disorder herself, and the trauma of her childhood may increase this risk."
Read at Psychology Today
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