Symptoms and cognition in geriatric schizophrenia

From the first manifestation of schizophrenic psychosis onwards numerous psychopathological symptoms and cognitive impairments occur, which are affected by age and the aging process. Clinical trials report a pronounced incidence of positive symptoms in late-onset schizophrenia. Negative symptoms are often observed in chronic-course psychosis, but occur infrequently in late-onset-schizophrenia. With respect to cognitive performance neuropsychological studies have shown a decrease in the test performance of permanently hospitalised patients with chronic schizophrenia as age and illness duration increased. Comparative studies of early and late-onset patients in most cases have reported no differing profiles of cognitive performance. Some investigators propose that late-onset schizophrenia may be a prodromal symptom of dementia. However, current studies show that late-onset schizophrenia is basically comparable to its early-onset counterpart. The manifestation in youth and early adulthood may be prevented by specific protective factors until aging-related parameters lead to the onset of symptoms during late life.