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Cognitive performance was examined longitudinally with linear mixed-effects models, and yearly differences between incident dementia cases and controls were examined in the six years prior to diagnosis. Results: Forty participants (25.2%) developed dementia over the follow-up period (\u2018incident dementia cases\u2019). Alzheimer\u2019s disease was the most common presumed etiology, though this was likely a result of sampling biases within NACC. Incident dementia cases showed declining trajectories in memory, language, and speeded attention two years prior to dementia onset. Conclusion: In a sample of BD patients enriched for Alzheimer\u2019s type dementia, prodromal dementia in BD can be detected up to two years before onset using the same cognitive tests used in psychiatrically-healthy older adults (i.e., measures of verbal recall and fluency). Cognition in the natural course of BD is generally stable, and impairment or marked decline on measures of verbal episodic memory or semantic retrieval may indicate an early neurodegenerative process.<\/jats:p>","DOI":"10.3233\/jad-201240","type":"journal-article","created":{"date-parts":[[2021,6,1]],"date-time":"2021-06-01T15:58:07Z","timestamp":1622563087000},"page":"737-748","source":"Crossref","is-referenced-by-count":11,"title":["How Does Dementia Begin to Manifest in Bipolar Disorder? A Description of Prodromal Clinical and Cognitive Changes"],"prefix":"10.1177","volume":"82","author":[{"given":"Brandy L.","family":"Callahan","sequence":"first","affiliation":[{"name":"University of Calgary, Department of Psychology, Calgary, AB, Canada"},{"name":"Hotchkiss Brain Institute, Calgary, AB, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"McLaren-Gradinaru","sequence":"additional","affiliation":[{"name":"University of Calgary, Department of Psychology, Calgary, AB, Canada"},{"name":"Hotchkiss Brain Institute, Calgary, AB, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ford","family":"Burles","sequence":"additional","affiliation":[{"name":"University of Calgary, Department of Psychology, Calgary, AB, Canada"},{"name":"Hotchkiss Brain Institute, Calgary, AB, 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