Long-term outcome of late-onset schizophrenia: 5-year follow-up study

• Published in: British journal of psychiatry Vol. 183; no. 3; pp. 213 - 219
• Main Authors: Brodaty, Henry, Sachdev, Perminder, Koschera, Annette, Monk, Dorothy, Cullen, Breda
• Format: Journal Article
• Language: English
• Published: Cambridge, UK Cambridge University Press 01.09.2003; RCP
• Subjects: Activities of daily living; Activities of Daily Living - psychology; Age; Age of Onset; Aged; Aged, 80 and over; Alzheimer's disease; Brain research; Cognitive ability; Cognitive functioning; Cognitive impairment; Dementia; Dementia - etiology; Dementia - psychology; Dementia disorders; Female; Follow-Up Studies; Humans; Illnesses; Late onset; Long term; Male; Memory; Mental disorders; Mentally ill older people; Middle Aged; NMR; Nuclear magnetic resonance; Older people; Prodromal symptoms; Prognosis; Psychiatric Status Rating Scales; Psychiatrists; Psychiatry; Psychopathology; Psychosis; Schizophrenia; Schizophrenia - complications; Schizophrenic Psychology; Time Factors; Vascular dementia; Australia
• ISSN: 0007-1250; 1472-1465
• DOI: 10.1192/bjp.183.3.213

There is controversy about whether late-onset schizophrenia is a precursor of cognitive decline. To examine the long-term outcome of a group of patients with late-onset schizophrenia. Patients with onset of DSM-III-R schizophrenia at age 50 years or over, but without dementia, and a healthy control group were assessed at baseline (n=27 and n=34, respectively), after 1 year and after 5 years (n=19 and n=24, respectively) on measures of psychopathology, cognition and general functioning, and compared on rates of decline and incidence of dementia. Nine patients with late-onset schizophrenia and none of the control group were found to have dementia (5 Alzheimer type, 1 vascular, 3 dementia of unknown type) at 5-year follow-up. There appeared to be a subgroup of late-onset schizophrenia patients without signs of dementia at baseline or at 1 year follow-up who subsequently declined. Late-onset schizophrenia may be a prodrome of Alzheimer-type dementia. More longitudinal studies are required to determine its nosological status.