Perceived cognitive failures and quality of life for older adults with bipolar disorder

Background: Older adults with bipolar disorder (BD) commonly present with cognitive deficits (e.g., attention, memory, verbal fluency). Concomitantly, older adults with BD commonly report subjective or perceived cognitive failures. For this study, we confirmed a 3-factor model of cognitive failures first validated with older adults free of mental illness (i.e., forgetfulness, distractibility, false triggering). We then computed a structural equation model (SEM) demonstrating the construct validity of perceived cognitive errors in relation to quality of life with BD. Use of SEM enabled us to measure quality of life broadly and germane to BD (i.e., well-being, life satisfaction, alcohol misuse, sleep quality). Methods: We obtained responses from an international sample of 350 older adults with BD (M = 61.26 years of age, range 50–87), recruited via micro-targeted social media advertising. Most lived in Canada, the U.S., U.K., Ireland, Australia and South Africa. Results: As hypothesized, perceived cognitive failures were predicted by BD symptoms (depression and hypo/mania). And cognitive failures directly and indirectly predicted quality of life. Limitations: Future research is needed to replicate this QoL model over time with younger patients and those recruited using more traditional methods. Conclusions: Perceived cognitive failures may not be strongly correlated with objective indices of cognitive deficits; nonetheless perceived cognitive failures are significantly associated with quality of life for older adults with BD. For both cognitive errors and BD symptoms, their indirect effect on quality of life (via suicide ideation) is greater than the direct effect.