Late-onset-psychosis: cognition

Abstract

The present results suggest cognitive deficits (mostly of executive functions) and vascular and neurodegenerative vulnerability in LOPS. Further studies with larger samples are needed to confirm the present findings.

Elderly patients with very late-onset schizophrenia-like psychosis and early-onset schizophrenia: Cross-sectional and retrospective clinical findings

“…The detailed method and cognitive results were presented in a previous report [39]. In summary, although VLOSLP and EOS patients did not meet the diagnostic criteria for dementia at onset of the psychotic disorder, the results showed that the groups presented at follow-up with cognitive deficits in several domains, and 20% of VLOSLP had developed dementia overtime (after onset of psychotic disorders) compared to 5.9% of EOS [39].…”

“…Both groups presented with vascular risk factors, and 69% of the VLOSLP for whom neuroimaging data were available at follow-up presented abnormalities, mostly vascular. Only 6/17 EOS had CT-scans and abnormal findings were reported in 33% of these patients (see Girard et al [39], for further details and dosages of medications). Few active symptoms of depression and/or anxiety were present in a small number of patients at the current evaluation (follow-up) whereas most patients suffered from significant anxious and depressive symptoms in the past.…”

“…This could be explained by a sample bias as the present community volunteer EOS were perhaps less affected by the pathology than patients in other studies, and conversely, the VLOSLP or a proportion of VLOSLP were probably more cognitively impaired at follow-up. Indeed, 80% -93.3% of the VLOSLP patients (depending on the psychiatrist or neuropsychologist who made the diagnosis see [39] for the method of consensus dementia/cognitive impairment diagnosis at follow-up) had cognitive deficits at followup and 20% evolved towards dementia over a mean period of 2.4 (3.1 SD) years after the onset of psychosis [39]. In addition, the ILOS Group proposed that visual hallucinations would be more prevalent in VLOSLP than in EOS [5].…”

“…It is also possible that some symptoms such as reduced facial expression and energy might be extrapyramidal side effects of the medication rather than intrinsic negative symptoms [42]. However, this is less likely given that extrapyramidal side effects are more common in typical than in atypical neuroleptics, and that most VLOSLP (16/17) received atypical neuroleptics at an inferior percentage of maximum dose than EOS (22.8% versus 50.2% for, respectively, VLOSLP and EOS [39]). …”

“…Research design and settings: This was a betweenpatient comparison study made at follow-up, with a retrospective component (onset of the psychotic disorder), following the historical cohort [39]. Patients were recruited in psychiatric/geriatric psychiatry units of five hospitals in the province of Quebec, Canada.…”