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S012-4

Differences in Cognition and Social Functioning of Community-Dwelling Older
Patients with Bipolar Ddisorder and Schizphrenia

Shang-Ying Tsai

Taipei Medical University & Hospital, Taiwan

Background/Objective: Evidence in both older patients with bipolar disorder (BD) and with
schizophrenia (SZ) demonstrates serious and pervasive cognitive deficits. In contrast,
community-dwelling patients with either BD or SZ in late life may represent a survivor cohort and,
therefore, be considered as a collective group to explore their own characteristics. Researches on
younger individuals with schizophrenia have shown that social skills deficits are both common and
distinguish the disease from BD. However, less research has focused on differences in cognitive
function and social functioning between older persons with BD and SZ. Particularly, the non-Western
reports are scarce.

Method: The existing Western reports regarding the comparisons of cognition and psychosocial
function between SZ and BD in late life will be discussed. With consideration of cross-cultural
difference in support system, we will present the comparisons of the Asian community-dwelling
older adults with BD (N=73; mean age= 60.2± 8.6 years) and SZ (N=112; mean age=57.6± 7.9 years)
in Taiwan.

Result: Western studies show that middle-aged and older community-dwelling adults with BD have
greater short-term variability in level of neurocognitive functioning relative to SZ patients. Unlike
the Western reports, more than 80% of our patients lived with their family members, 87.7% of BD
and 80.4% of SZ. The BD patients appeared as impaired as SZ ones on Mini-Mental State
Examination, 24.9± 5.1 and 25.1± 5.2, respectively, verbal fluency and Clock Drawing Test.
However, BD patients had significantly higher scores on Global Assessment of Functioning Scale
and Strauss-Carpenter Levels of Functioning than SZ.

Conclusion: Cardiovascular diseases are common in patients with BD and SZ in late life. Older BD
patients tend to have an even higher medical illness burden than SZ ones. Given the bidirectional
relationship between physical and mental function, integrated care that addresses medical and
psychiatric illness together is needed to optimize health outcomes for this vulnerable group of
patients.