Cognitive decline in late-life schizophrenia: a longitudinal study of geriatric chronically hospitalized patients

Harvey, Philip D.; Silverman, Jeremy M.; Mohs, Richard C.; Parrella, Michael; White, Leonard; Powchik, Peter; Davidson, Michael; Davis, Kenneth L.

doi:10.1016/s0006-3223(98)00273-x

Cited by 221 publications

(135 citation statements)

References 31 publications

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“…Using patients drawn from the same sample of institutionalized patients referenced above Harvey et al, 1995), longitudinal follow-up studies suggested an easily detected worsening in cognition over follow-up intervals of 2.5 (Harvey et al, 1999) and 6 (Friedman et al, 2001) years, with risk for worsening increasing only after the age of 65 (Friedman et al, 2001). These cognitive declines predicted subsequent functional declines (Harvey et al, 1999;Friedman et al, 2001) and patients could be classified at a baseline assessment into cognitive subtypes that predicted stability versus decline in cognitive and functional status over a 6-year follow-up (Bowie et al, 2004). Further, a 10-year epidemiological follow-up study of first admission patients who were living in the community found significant declines in visual spatial skills and visual memory over that period, with those cognitive declines also related to functional declines (Stirling et al, 2003).…”

Section: Introductionmentioning

confidence: 99%

“…The outpatients in this study, however, were relatively young, with a mean age of 47.6 (SD=15.7). Using patients drawn from the same sample of institutionalized patients referenced above Harvey et al, 1995), longitudinal follow-up studies suggested an easily detected worsening in cognition over follow-up intervals of 2.5 (Harvey et al, 1999) and 6 (Friedman et al, 2001) years, with risk for worsening increasing only after the age of 65 (Friedman et al, 2001). These cognitive declines predicted subsequent functional declines (Harvey et al, 1999;Friedman et al, 2001) and patients could be classified at a baseline assessment into cognitive subtypes that predicted stability versus decline in cognitive and functional status over a 6-year follow-up (Bowie et al, 2004).…”

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Age-associated differences in cognitive performance in older community dwelling schizophrenia patients: Differential sensitivity of clinical neuropsychological and experimental information processing tests

Bowie

Reichenberg

McClure

et al. 2008

Schizophrenia Research

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Cognitive dysfunction is a common feature of schizophrenia and deficits are present before the onset of psychosis, and are moderate to severe by the time of the first episode. Controversy exists over the course of cognitive dysfunction after the first episode. This study examined age-associated differences in performance on clinical neuropsychological (NP) and information processing tasks in a sample of geriatric community living schizophrenia patients (n=172). Compared to healthy control subjects (n=70), people with schizophrenia did not differ on NP tests across age groups but showed evidence for age-associated cognitive worsening on the more complex components of an information-processing test. Age-related changes in cognitive function in schizophrenia may be a function of both the course of illness and the processing demands of the cognitive measure of interest. Tests with fixed difficulty, such as clinical NP tests, may differ in their sensitivity from tests for which parametric difficulty manipulations can be performed. Dr. Bowie was involved in literature review, data analysis and interpretation and writing of the manuscript. Dr. Reichenberg was involved in data analysis and interpretation. Dr. McClure was involved in data interpretation and manuscript writing. Dr. Leung was involved in literature review and manuscript writing. Dr. Harvey designed the study, wrote the research protocol, and was involved in writing the manuscript. All authors contributed to and have approved the final manuscript.Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. , 1997) or a global measure of dementia severity (Eyler Zorrila et al., 2000). In contrast, several cross-sectional studies of chronically institutionalized "poor-outcome" schizophrenia patients suggest worsening of cognitive impairment over the lifespan. For example, Davidson et al. (1995) found differences in scores on the Mini Mental State Examination across adjacent 10-year age-groups ranging from 25 to 95, with a resulting difference in performance of over 15 points when the 25-35 year olds were compared to those over 85. Similar findings were reported by Arnold et al. (1995). An additional cross-sectional analysis of a larger sample with an age range extending to also 95 years found evidence for age-related differences in cognitive performance across 22 items from standardized neuropsychological (NP) tests designed for use in the elderly .Using a comprehensive NP battery and longitudinal methodology, Heaton and colleagues (2001) found no evidence for cognitive decline regardless of age, illness variables, or ...

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Section: Introductionmentioning

confidence: 99%

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confidence: 99%

Age-associated differences in cognitive performance in older community dwelling schizophrenia patients: Differential sensitivity of clinical neuropsychological and experimental information processing tests

Bowie

Reichenberg

McClure

et al. 2008

Schizophrenia Research

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“…Les symptômes positifs, parfois intenses, sont retrouvés par différentes études évaluant des patients âgés institutionnalisés ou ambulatoires [13,23]. Les symptômes négatifs s'aggravent lors du vieillissement [13].…”

Section: Tableaux Cliniques Rencontrés Chez Les Patients Souffrant Deunclassified

“…Les symptômes négatifs s'aggravent lors du vieillissement [13]. Les troubles de la pensée et de la communication persistent lors du vieillissement ; l'appauvrissement qui progresse peut masquer en partie l'importance de la désorganisation de la pensée [23].…”

Section: Tableaux Cliniques Rencontrés Chez Les Patients Souffrant Deunclassified

“…Certains patients âgés présentent une relative stabilité cognitive, tandis que d'autres patients, dont l'évolution clinique a été défavorable, avec une persistance de symptômes chroniques, présentent un niveau de dégradation important lorsqu'ils sont âgés [13,19,[23][24][25]. La présence de troubles cognitifs est associée à un mauvais pronostic général de la maladie [26], en particulier fonctionnel [18].…”

Section: Fonctions Cognitivesunclassified

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Schizophrénie et vieillissement : aspects cliniques

Jalenques

Legrand²,

Tourtauchaux³

et al. 2009

Annales Médico-psychologiques, revue psychiatrique

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RésuméLe nombre de patients âgés souffrant d'une schizophrénie chronique augmente ; il devrait doubler dans les vingt prochaines années. Avec l'âge avancé, les symptômes positifs de schizophrénie s'amenuisent et une majorité de patients souffrent surtout de symptômes négatifs et de déficits cognitifs. La dépression et les comorbidités somatiques sont également fréquentes. L'amélioration de la qualité des soins repose sur la prise en compte par les psychiatres des particularités diagnostiques et de prise en charge de ces patients. AbstractThe number of older people with chronic schizophrenia increases and is expected to double over the next two decades. Along with a reduction in positive schizophrenic symptoms Page 2 of 12 A c c e p t e d M a n u s c r i p t 2 with increasing age, a majority suffers from negative symptoms and cognitive deficits.Depression and co-morbid medical problems are also frequent. These complex clinical and service needs have to be the focus of interest of psychiatrists to improve quality of care.

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Schizophrenia as a Disorder of Developmentally Reduced Synaptic Connectivity

McGlashan¹,

Hoffman²

2000

Archives of General Psychiatry

598

362

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Recent postmortem and neuroimaging studies of schizophrenia delineate changes in brain structure and volume that appear to arise from a reduction of neuritic processes (such as dendrites and synapses) rather than loss of neuronal or glial cell bodies. To account for these findings, we propose a pathophysiological model of reduced synaptic connectivity arising from disturbances of brain development active during perinatal and adolescent periods. We review a computer simulation of the elimination of the synaptic connections that models normal cognitive development and psychotic symptom formation. We describe the model's key parameters and discuss how they can account for important aspects of schizophrenia, including its unique symptoms, short- and long-term course, typical age of onset, neurodevelopmental deficits, limited neurodegenerative progression, sex differences, and more. We discuss some of the model's predictions and questions raised for basic research, early detection, and preventive intervention.

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Cognitive decline in late-life schizophrenia: a longitudinal study of geriatric chronically hospitalized patients

Cited by 221 publications

References 31 publications

Age-associated differences in cognitive performance in older community dwelling schizophrenia patients: Differential sensitivity of clinical neuropsychological and experimental information processing tests

Age-associated differences in cognitive performance in older community dwelling schizophrenia patients: Differential sensitivity of clinical neuropsychological and experimental information processing tests

Schizophrénie et vieillissement : aspects cliniques

Schizophrenia as a Disorder of Developmentally Reduced Synaptic Connectivity

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