Dementia among older people with schizophrenia: an update on recent studies

Abstract

Purpose of reviewThis narrative review examines recently published research that examines the prevalence, underlying causes, and treatments for dementia among people with schizophrenia.Recent findingsPeople with schizophrenia have high rates of dementia, compared with the general population, and cognitive decline has been observed 14 years prior to onset of psychosis with accelerated decline in middle age. Underlying mechanisms of cognitive decline in schizophrenia include low cognitive reserve, accelerated cognitive aging, cerebrovascular disease and medication exposure. Although pharmacologic, psychosocial and lifestyle interventions show early promise for preventing and mitigating cognitive decline, few studies have been conducted in older people with schizophrenia.SummaryRecent evidence supports accelerated cognitive decline and brain changes in middle-aged and older people with schizophrenia, relative to the general population. More research in older people with schizophrenia is needed to tailor existing cognitive interventions and develop novel approaches for this vulnerable and high-risk group.

Identifying modifiable comorbidities of schizophrenia by integrating electronic health records and polygenic risk

“…This set includes several interesting phenotypes such as "tobacco use disorder," "diabetes" and "dementias" where prior work has implicated genetic sharing and similar etiologies. [70][71][72][73][74][75] Our results would suggest that the genetic risk of schizophrenia is not the primary contributing factor to these comorbidities supporting other potential hypotheses and with potential for intervention. In fact, these results indicate that genetic risk of schizophrenia decreases risk of diabetes despite very high comorbidity providing an even stronger case for other contributors such as medication.…”

Integrating Electronic Health Records and Polygenic Risk to Identify Genetically Unrelated Comorbidities of Schizophrenia That May Be Modifiable

“…Even for the most significant PRS associations among this set, the effect sizes are quite small (variance explained < 0.5%), potentially pointing to nongenetic causes as primary drivers of comorbidities. This set includes several interesting phenotypes such as tobacco use disorder, diabetes, and dementias, where prior work has implicated genetic sharing and similar etiologies ( 78 , 79 , 80 , 81 , 82 , 83 ). Our results suggest that the genetic risk of schizophrenia is not the primary contributing factor to these comorbidities, supporting other potential hypotheses and with potential for intervention.…”

Evaluation of the Influence of Clinical History on the Occurrence of Dementia Using the Database of National Health Insurance in Japan

“…Furthermore, our findings of multivariate adjusted ORs showed that a clinical history of schizophrenia 5 and 10 years ago was related to an increased incidence of dementia. Recent studies have demonstrated rapid cognitive decline and brain changes in middleaged and older individuals with schizophrenia compared to healthy individuals [36].…”