Cognitive impairment in schizophrenia across age groups: a case–control study

Abstract

BackgroundThe potential dynamics of cognitive impairment in schizophrenia is discussed in the literature of the field. Recent publications suggest modest changes in level of cognitive impairment after first psychotic episode. Present article attempts to explore cognitive differences between patients and controls across age groups and differences between age groups in clinical group.MethodsOne hundred and twenty-eight hospitalized patients with schizophrenia (64 women and 64 men) and 68 individuals from the control group (32 women and 32 men) aged 18–55 years were examined. The patients were divided into age groups (18–25, 26–35, 36–45, 46–55). Both groups were examined using Wisconsin Card Sorting Test, Rey Auditory Verbal Learning Test, Rey Osterrieth Complex Figure Test, Trail Making Test (A and B), Stroop Test, verbal fluency test and Wechsler digit span.ResultsPatients with schizophrenia obtained significantly lower scores versus the control group in regard to all the measured cognitive functions (Mann–Whitney U; p < 0.05. Most deficits were present in all age groups, however, statistically important impairment in executive functions (WCST) were present only in “older” groups.ConclusionsPatients with schizophrenia obtained less favourable results than the control group in all age groups. Deficits regarding executive functions do not seem to be at a significant level among the youngest group, whereas they are more noticeable in the group of 46–55-year-olds. Executive functions are significantly lowered in the group aged 36–45 in comparison to the “younger” groups. The level of cognitive functions shows a mild exacerbation in connection with age, whereas cognitive rigidity proved to be related to the number of years spent without hospital treatment.

A Meta-Analysis of Executive Functions in Frontal Cortex: Comparing Healthy and Neuropsychiatric Groups

“…The frontal lobes show the larger decreases relative to global cerebral volume, and the frontal horns of the ventricles show the smallest relative increases(32). This discrepancy suggests that while changes in neural structures related to schizophrenia play a role, comorbid risk factors like substance abuse(33), poor medication compliance(34), or fewer protective factors(35) may also be contributing to reductions in frontal lobe volume, which are more salient for poor outcome patients. Given the transdiagnostic predictive validity of EF, early onset and changes in frontal regions may lead to decreased functional status and its associated risk factors.…”

A Comparison of Methamphetamine-Induced Psychosis and Schizophrenia: A Review of Positive, Negative, and Cognitive Symptomatology

“…Furthermore, antipsychotic medication appears to have minimal positive impact, if at all, on the cognitive difficulties associated with schizophrenia ( 80 ). Executive function appears to be the most compromised and conserved cognitive deficit across patients with schizophrenia ( 81 , 82 ), with executive deficits shown to be the most pervasive amongst older adults with schizophrenia ( 83 ) and negatively impacted by number of psychotic episodes ( 84 ). Additionally, the fact that the cognitive issues in schizophrenia are deleterious to social functioning, functional outcomes ( 85 , 86 ), independence ( 87 , 88 ), recovery ( 89 ), and well-being ( 90 ) has prompted the argument that cognitive dysfunction should be regarded as one of the core dimensions in the disease, particularly with respect to DSM-5 diagnostic criteria ( 61 ).…”

Comparison of Clinical and Sociodemographic Characteristics of Patients with Schizophrenia Treated Stationary and at Day Hospital

“…Furthermore, the level of education was examined, and in both groups 73% of participants completed secondary education and 15% of the participants have college education. Such information is not surprising, given that schizophrenia as a disease affects a person's cognitive functioning, which can consequently affect educational status [18], and ultimately, work function [19]. Therefore, patients treated at Day Hospital, Recent studies show however, that the employment rate in patients with schizophrenia is generally lower than the employment rate in patients with other psychotic disorders and is about 6 to 7 times lower than in the healthy population, making it the largest group benefiting from financial support due to disability.…”