{
  "abstract": "Background: Cognitive deficits are one of the core features of older-age bipolar disorder (OABD). Psychotropic medications may influence cognition, especially in older populations, where anticholinergic effects are relevant. This cross-sectional study aimed to investigate the potential impact of anticholinergic load on cognitive performance in individuals with OABD.\n\nMethods: One hundred and twenty-one euthymic or partially remitted OABD patients were included. Cognitive performance was assessed using a neuropsychological battery and summarized into attention, processing speed, working memory, visual and verbal memory, and executive functions. Anticholinergic load was assessed using the CRIDECO Anticholinergic Load Scale (CALS), and pharmacological burden was quantified using the defined daily dose (DDD). Associations were examined using hierarchical multivariable linear regression models, considering also relevant clinical covariates.\n\nResults: The interaction between CALS and DDD was associated with lower visual and verbal memory scores (p = 0.04). Age was inversely associated with cognitive performance across all domains (all p < 0.01). A higher number of manic episodes was associated with poorer attention, visual and verbal memory, and processing speed (all p < 0.01). Lifetime psychotic symptoms were associated with worse working memory (p = 0.02), and higher diazepam-equivalent doses were associated with worse visual and verbal memory performance (p = 0.02).\n\nConclusions: Although anticholinergic medications may contribute to cognitive burden, their impact appears dose-related and limited compared with the broader influence of illness-related factors. In OABD patients, prioritizing the management of illness-related characteristics alongside careful pharmacological management may therefore be crucial for preserving cognitive functioning.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Molecular Medicine, School of Medicine, University of Siena, Siena, Italy",
    "Bipolar and Depressive Disorders Unit, Hospital Clinic de Barcelona, Barcelona, Spain",
    "Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain",
    "Departament de Medicina, Facultat de Medicina i Ciències de la Salut, Institut de Neurociències, Universitat de Barcelona (UBNeuro), Barcelona, Spain",
    "Sleep Disorders Unit, Hospital Clinic de Barcelona, Barcelona, Spain",
    "Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain"
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 16,
  "authors": [
    {
      "affs": [
        0,
        1,
        2
      ],
      "name": "Simone Pardossi",
      "orcid": "0009-0004-3002-529X"
    },
    {
      "affs": [
        2
      ],
      "name": "Brisa Solé",
      "orcid": "0000-0003-1673-8248"
    },
    {
      "affs": [
        1,
        2,
        3
      ],
      "name": "Andrea Ruiz",
      "orcid": "0009-0006-8922-8758"
    },
    {
      "affs": [
        1,
        2,
        3
      ],
      "name": "Marta Bort",
      "orcid": "0009-0007-7217-5319"
    },
    {
      "affs": [
        1,
        2,
        3
      ],
      "name": "Arturo Rodríguez-Rey"
    },
    {
      "affs": [
        1,
        2,
        3
      ],
      "name": "Ainara Espluga",
      "orcid": "0009-0007-5152-2828"
    },
    {
      "affs": [
        1,
        2,
        3
      ],
      "name": "Meritxell González-Campos"
    },
    {
      "affs": [
        1,
        2,
        3
      ],
      "name": "Marc Valentí"
    },
    {
      "affs": [
        1,
        2,
        3
      ],
      "name": "Giovanna Fico",
      "orcid": "0000-0003-1785-7126"
    },
    {
      "affs": [
        1,
        2,
        3,
        4
      ],
      "name": "Andrea Murru"
    },
    {
      "affs": [
        1,
        2,
        3,
        5
      ],
      "name": "Jose Sanchez-Moreno",
      "orcid": "0000-0003-1520-093X"
    },
    {
      "affs": [
        1,
        2,
        3,
        5
      ],
      "name": "Anabel Martinez-Aran",
      "orcid": "0000-0002-0623-6263"
    },
    {
      "affs": [
        0
      ],
      "name": "Andrea Fagiolini"
    },
    {
      "affs": [
        1,
        2,
        3,
        5
      ],
      "name": "Eduard Vieta",
      "orcid": "0000-0002-0548-0053"
    },
    {
      "affs": [
        1,
        2,
        3,
        5
      ],
      "name": "Michele De Prisco",
      "orcid": "0000-0002-2032-1181"
    },
    {
      "affs": [
        1,
        2,
        3,
        5
      ],
      "name": "Laura Montejo"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/69jpbm8xvsajb.bib",
  "cited_by": 0,
  "doi": "10.1192/j.eurpsy.2026.12247",
  "fulltext_url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC13735821/",
  "id": "69jpbm8xvsajb",
  "issns": [
    "0924-9338",
    "1778-3585"
  ],
  "landing_url": "https://doi.org/10.1192/j.eurpsy.2026.12247",
  "language": "en",
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Research Article"
    ],
    [
      "openalex",
      "2738|Bipolar Disorder and Treatment"
    ]
  ],
  "openalex": "W7171985492",
  "pdf_url": "https://www.cambridge.org/core/services/aop-cambridge-core/content/view/C51AF928774D35751E61847CB00CB3CD/S0924933826122470a.pdf/div-class-title-cognitive-performance-in-older-age-bipolar-disorder-a-cross-sectional-study-of-anticholinergic-load-and-clinical-characteristics-div.pdf",
  "pmcid": "PMC13735821",
  "pmid": "42533445",
  "published": "2026-07-31",
  "publisher": "Cambridge University Press",
  "ris": "https://research.draconitic.com/paper/69jpbm8xvsajb.ris",
  "sources": [
    {
      "first_seen": "2026-11-09T12:21:25Z",
      "native_id": "PMC13735821",
      "source": "pmc",
      "url": "https://doi.org/10.1192/j.eurpsy.2026.12247"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2738|Bipolar Disorder and Treatment",
      "subfield": "psychiatry"
    }
  ],
  "title": "Cognitive performance in older-age bipolar disorder: A cross-sectional study of anticholinergic load and clinical characteristics",
  "title_text": "Cognitive performance in older-age bipolar disorder: A cross-sectional study of anticholinergic load and clinical characteristics",
  "type": "peer-reviewed",
  "updated_at": "2026-11-09T12:21:25Z",
  "url": "https://research.draconitic.com/paper/69jpbm8xvsajb",
  "venue": "European Psychiatry",
  "versions": []
}