Research report| Volume 33, ISSUE 4, P255-260, February 15, 1993

Severe cognitive impairment in elderly schizophrenic patients: A clinicopathological study

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      The severe cognitive impairment that affects many of the elderly schizophrenic patients could represent the outcome of schizophrenia in old age for the very severe and chronically ill patients or may be the result of lengthy institutionalization and somatic treatment. Alternatively, it could be due to the presence of concurrent dementing disorders, such as Alzheimer's disease (AD) or multi-infarct dementia. Using an identical neuropathological protocol, brain specimens from schizophrenic patients who showed evidence of severe cognitive impairment were compared with 12 age-matched control cases and the same number of age-matched cases of neuropathologically confirmed patients with AD. Despite their relatively advanced age (mean age 77.1 years ± 2.8), none of the schizophrenia cases showed sufficient degree of senile plaques and neurofibrillary tangle formations to confirm a diagnosis of AD. Other neurodegenerative disorders associated with dementia were also not identified. These studies suggest that alternative explanations need to be sought for the severe cognitive impairment commonly encountered in elderly schizophrenic patients.


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        • Buhrich N.
        • Crow T.J.
        • Johnstone E.C.
        • Owens D.G.C.
        Age disorientation in chronic schizophrenia is not associated with premorbid intellectual impairment or past physical treatment.
        Br J Psychiatry. 1988; 152: 466-469
        • Burton C.J.
        • Crow T.J.
        • Frith C.D.
        • et al.
        Schizophrenia and the brain: a prospective clinico-neuropathological study.
        Psychol Med. 1990; 20: 285-309
        • El-Mallakh R.S.
        • Kirch D.G.
        • Shelton R.
        • et al.
        The nucleus basalis of Meynert, senile plaques and intellectual impairment in schizophrenia.
        J Neuropsychiatry. 1991; 3: 383-386
        • Harrow M.
        • Marengo J.
        • Pogue-Geile M.
        • Pawelski T.J.
        Schizophrenia and Aging: Schizophrenia, Paranoia, and Schizophreniform Disorders Later in Life.
        Guilford Press, New York1987
        • Harvey P.D.
        • Davidson M.
        • Powchik P.
        • Parrella M.
        • White L.
        • Mohs R.
        Assessment of dementia in elderly schizophrenics and aging.
        Schizophr Res. 1992; 7: 85-90
        • Heaton R.K.
        • Drexler M.
        Clinical neuropsychological findings in schizophrenia and aging.
        in: Miller N.E. Cohen G.D. Schizophrenia and Aging. Guilford Press, New York1987
        • Hughes C.P.
        • Berg L.
        • Danzier W.L.
        • et al.
        A new clinical scale for staging of dementia.
        Br J Psychiatry. 1982; 140: 566-572
        • Johnstone E.C.
        • Owens D.G.C.
        • Gold A.
        • Crow T.J.
        • Macmillan J.F.
        Institutionalization and the defects of schizophrenia.
        Br J Psychiatry. 1981; 139: 195-203
        • Khachaturian Z.S.
        Diagnosis of Alzheimer's disease.
        Arch Neurol. 1985; 42: 1097-1105
        • Kirkpatrick B.
        • Golden R.N.
        • Fletcher R.H.
        Is there a dementia of schizophrenia.
        Psychol Med. 1987; 4: 253-263
        • Kraepelin E.
        Dementia Praecox and Paraphrenia.
        R.E. Krieger, New York1919
        • Schulz S.C.
        • Condley R.R.
        • Kahn E.M.
        • Alexander J.
        Nonresponders to neuroleptics: a distinct subtype.
        in: Schulz S.C. Tamminga C.A. Schizophrenia: Scientific Progress. Oxford Univ Press, Oxford1989: 341-350
        • Tamlyn A.
        • McKenna P.J.
        • Mortimer A.M.
        • Lund C.E.
        • Hammond S.
        • Baddeley A.D.
        Memory impairment in schizophrenia: its extent, affiliations and neuropsychological character.
        Psychol Med. 1992; 22: 1-15
        • Wing J.K.
        • Brown J.
        Institutionalism and Schizophrenia.
        Cambridge Univ Press, London1970