This review focuses on assessing the prevalence and risk factors of mental disorders in older people in the modern era, including the COVID-19 pandemic. A systematic review of the literature was conducted in PubMed, Elsevier, and Google using keywords over the past 10 years. Substantial discrepancy of data on the prevalence of psychiatric disorders has been shown in the elderly population. The significant incidence of mental disorders among nursing home residents is highlighted. The relevance of nonpsychotic depressive and anxiety disorders is demonstrated for the elderly, along with the difficulty of diagnosing mental disorders associated with physical pathology and cognitive impairments. The risk factors for mental disorders in older adults are socio-demographic but also economic, psychological, and physical. The problem of mental health of the elderly is characterized for the conditions of the COVID-19 pandemic associated with specific risk factors for psychiatric disorders. The shortage of evidence-based research in the treatment of mental disorders in the elderly and the urgency to improve the organization of psychiatric care for such patients are noted. Understanding the structure and prevalence of mental disorders among the elderly will allow optimizing the functioning of healthcare systems.
Currently it is well known that schizophrenia is associated with cognitive impairment. Still there are many unresolved questions, such as whether cognitive deficit is total, what are the relationships of cognitive impairment with clinical features, demographic characteristics and different biomarkers, which could shed light on its pathogenesis. The aim of our study was to characterize cognitive impairment in schizophrenia and to find factors that may contribute to it. Sixty patients with paranoid schizophrenia were examined. BACS, Rey-Osterreith complex figure and correction task were used to assess cognitive functioning. Only 14.3% of patients had BACS score in the normal range. The vast majority of them showed impaired motor function, verbal and visual memory. Cognitive functioning did not worsen with time. Working memory impairment was influenced by genetic predisposition to schizophrenia and age of disease onset. Residual positive symptoms led to a decrease in the speed of skill development. Symptoms of anxiety and depression contributed to the impairment of accuracy. Hypomania was associated with impaired planning. Planning and problem-solving behavior did not correlate with other cognitive functions, which makes them isolated domains. Higher levels of NSE had been found in patients with more severe memory impairment. S100B level was associated with safer constructive abilities. In general, cognitive impairment in schizophrenia, although present in the majority of patients, varies a lot and appears selective and dependent on certain clinical features.The study was supported by RSCF 14-50-00069 grant.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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