Long-term follow-up and phenomenologic differences distinguish among late-onset schizophrenia, late-life depression, and progressive dementia.
OBJECTIVE
The diagnosis of patients with late-life onset of hallucinations and delusions but an absence of mood or cognitive disorder remains controversial. The authors used long-term follow-up and phenomenology to assess whether outcome varied by diagnosis.


METHODS
Twenty-eight individuals with late-life psychosis but no mood or cognitive disorder were compared with 48 individuals with late-life major depression and 47 individuals with psychotic symptoms and late-life dementia. All subjects were followed for a minimum of 1 year. Data from the last time examined were used to determine likelihood of death at 84 months by Kaplan-Meier analysis in all groups and the likelihood of developing dementia in the depression and late-life onset psychosis groups at 120 months.


RESULTS
Patients with dementia-plus-psychosis were more likely to die at 84 months than those with major depression or late-onset hallucinations and delusions. Subjects with depression or late-onset hallucinations and delusions did not differ in likelihood of developing dementia at 120 months.


CONCLUSIONS
These results support the hypothesis that a condition characterized by psychiatric symptoms and no mood symptoms can begin in later life and that this disorder is not a precursor to dementia.
Rabins
Peter V
PV
Departments of Psychiatry and Behavioral Sciences, Johns Hopkins Medical Institutions, Baltimore, MD 21287-7279, USA. pvrabins@jhmi.edu
Lavrisha
Martina
M
D000368:Aged; D000375:Aging / Q000523:psychology; D003704:Dementia / Q000175:diagnosis* / Q000523:psychology; D003863:Depression / Q000175:diagnosis*; D039721:Diagnostic and Statistical Manual of Mental Disorders; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D012559:Schizophrenia / Q000175:diagnosis*; D012720:Severity of Illness Index