Long-term outcome of late-onset schizophrenia: 5-year follow-up study.
BACKGROUND
There is controversy about whether late-onset schizophrenia is a precursor of cognitive decline.


OBJECTIVE
To examine the long-term outcome of a group of patients with late-onset schizophrenia.


METHODS
Patients with onset of DSM-III-R schizophrenia at age 50 years or over, but without dementia, and a healthy control group were assessed at baseline (n=27 and n=34, respectively), after 1 year and after 5 years (n=19 and n=24, respectively) on measures of psychopathology, cognition and general functioning, and compared on rates of decline and incidence of dementia.


RESULTS
Nine patients with late-onset schizophrenia and none of the control group were found to have dementia (5 Alzheimer type, 1 vascular, 3 dementia of unknown type) at 5-year follow-up. There appeared to be a subgroup of late-onset schizophrenia patients without signs of dementia at baseline or at 1 year follow-up who subsequently declined.


CONCLUSIONS
Late-onset schizophrenia may be a prodrome of Alzheimer-type dementia. More longitudinal studies are required to determine its nosological status.
Brodaty
Henry
H
School of Psychiatry, University of New South Wales, Sydney, Australia. hbrodaty@unsw.edu.au
Sachdev
Perminder
P
Koschera
Annette
A
Monk
Dorothy
D
Cullen
Breda
B
D000203:Activities of Daily Living / Q000523:psychology; D017668:Age of Onset; D000368:Aged; D000369:Aged, 80 and over; D003704:Dementia / Q000209:etiology* / Q000523:psychology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011569:Psychiatric Status Rating Scales; D012559:Schizophrenia / Q000150:complications*; D012565:Schizophrenic Psychology; D013997:Time Factors