The relationship of neuropsychological abilities to specific domains of functional capacity in older schizophrenia patients.
BACKGROUND
This study sought to determine the relative importance of cognitive measures in predicting various domains of everyday functional capacity in older outpatients with schizophrenia.


METHODS
Ninety-three psychiatry outpatients with diagnoses of schizophrenia and schizoaffective disorders underwent a comprehensive neuropsychiatric evaluation, including neuropsychological testing and clinical ratings of psychopathology. Functional capacity was assessed with the Direct Assessment of Functional Status, a performance measure of basic and instrumental activities of daily living (ADLs/IADLs).


RESULTS
Neuropsychological performance significantly predicted most ADLs/IADLs measured, except simple eating behaviors, time orientation, and grooming. Lower educational level and negative symptoms also were associated with worse functional capacity, whereas positive symptoms and depressed mood were not. Measures of cognitive functioning accounted for more variance in functional capacity than did psychiatric ratings of symptoms, and multiple regression analyses demonstrated that neuropsychological performance was predictive of functional capacity, over and above clinical symptoms. No specific cognitive domains were differentially predictive of specific domains of functional capacity.


CONCLUSIONS
Neurocognitive abilities were more predictive of functional capacity than level of clinical symptoms; however, these abilities were not specific predictors of functioning. This is consistent with findings of relatively generalized, intercorrelated cognitive impairment in schizophrenia and multiply determined domains of everyday functioning.
Evans
Jovier D
JD
Department of Psychiatry, University of California, San Diego, California, USA.
Heaton
Robert K
RK
Paulsen
Jane S
JS
Palmer
Barton W
BW
Patterson
Thomas
T
Jeste
Dilip V
DV
D000203:Activities of Daily Living / Q000523:psychology; D000368:Aged; D000375:Aging / Q000502:physiology*; D001288:Attention / Q000502:physiology; D005260:Female; D006801:Humans; D007858:Learning / Q000502:physiology; D008297:Male; D008570:Memory, Short-Term / Q000502:physiology; D008875:Middle Aged; D009483:Neuropsychological Tests / Q000706:statistics & numerical data*; D010045:Outpatients; D011569:Psychiatric Status Rating Scales; D011597:Psychomotor Performance / Q000502:physiology; D011618:Psychotic Disorders / Q000503:physiopathology / Q000523:psychology; D011897:Random Allocation; D012559:Schizophrenia / Q000503:physiopathology*; D012565:Schizophrenic Psychology