The Course of Functional Decline in Geriatric Patients With Schizophrenia

Harvey, Philip D.; Bertisch, Hillary; Friedman, Joseph I.; Marcus, Sue M.; Parrella, M. P.; White, Léonard D.; Davis, Kenneth L.

doi:10.1097/00019442-200311000-00005

Cited by 5 publications

(2 citation statements)

References 29 publications

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“…Schizophrenia is a paradigmatic disorder where cognitive deficits on the one hand are a core domain [8,70,71] and on the other hand are known to be an important determinant of functional outcome through their impact on the level of self-care and utilization of hospital services [72][73][74][75][76]. Overall, summing-up direct and indirect costs, schizophrenia is estimated to cost £ 13.1 billion per year in total in the UK [16,77].…”

Section: (D) Schizophreniamentioning

confidence: 99%

The impact of neuroscience on society: cognitive enhancement in neuropsychiatric disorders and in healthy people

Sahakian

Brühl

Cook

et al. 2015

Phil. Trans. R. Soc. B

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In addition to causing distress and disability to the individual, neuropsychiatric disorders are also extremely expensive to society and governments. These disorders are both common and debilitating and impact on cognition, functionality and wellbeing. Cognitive enhancing drugs, such as cholinesterase inhibitors and methylphenidate, are used to treat cognitive dysfunction in Alzheimer's disease and attention deficit hyperactivity disorder, respectively. Other cognitive enhancers include specific computerized cognitive training and devices. An example of a novel form of cognitive enhancement using the technological advancement of a game on an iPad that also acts to increase motivation is presented. Cognitive enhancing drugs, such as methylphenidate and modafinil, which were developed as treatments, are increasingly being used by healthy people. Modafinil not only affects ‘cold’ cognition, but also improves ‘hot’ cognition, such as emotion recognition and task-related motivation. The lifestyle use of ‘smart drugs' raises both safety concerns as well as ethical issues, including coercion and increasing disparity in society. As a society, we need to consider which forms of cognitive enhancement (e.g. pharmacological, exercise, lifelong learning) are acceptable and for which groups (e.g. military, doctors) under what conditions (e.g. war, shift work) and by what methods we would wish to improve and flourish.

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Section: (D) Schizophreniamentioning

confidence: 99%

The impact of neuroscience on society: cognitive enhancement in neuropsychiatric disorders and in healthy people

Sahakian

Brühl

Cook

et al. 2015

Phil. Trans. R. Soc. B

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“…komplett abgeklungen waren. In einer Querschnittsuntersuchung von Davidson et al[42] zeigten ältere chronisch hospitalisierte Patienten weniger Positiv-und mehr Negativsymptomatik als jüngere Patienten, während sich in der Langzeitstudie von Harvey et al[43] nach sechs Jahren die positiven Symptome nicht veränderten und die negativen Symptome nur bei Patienten mit hohem Funktionsniveau zu Untersuchungsbeginn bei der Nacherhebung verstärkt vorhanden waren. Es ist unklar, ob diese Verstärkung der Negativsymptomatik unmittelbar dem Krankheitsprozess oder den Begleitumständen der Behandlungwie der langen Institutionalisierung zuzuschreiben ist.…”

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Symptomatik und Kognition bei Schizophrenie im Alter

Schmid¹,

Lässer²,

Schröder³

2011

Fortschr Neurol Psychiatr

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From the first manifestation of schizophrenic psychosis onwards numerous psychopathological symptoms and cognitive impairments occur, which are affected by age and the aging process. Clinical trials report a pronounced incidence of positive symptoms in late-onset schizophrenia. Negative symptoms are often observed in chronic-course psychosis, but occur infrequently in late-onset-schizophrenia. With respect to cognitive performance neuropsychological studies have shown a decrease in the test performance of permanently hospitalised patients with chronic schizophrenia as age and illness duration increased. Comparative studies of early and late-onset patients in most cases have reported no differing profiles of cognitive performance. Some investigators propose that late-onset schizophrenia may be a prodromal symptom of dementia. However, current studies show that late-onset schizophrenia is basically comparable to its early-onset counterpart. The manifestation in youth and early adulthood may be prevented by specific protective factors until aging-related parameters lead to the onset of symptoms during late life.

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