title: Dementia in middle-aged patients with schizophrenia.
abstract: BACKGROUND
  Although numerous studies have assessed cognitive dysfunction in patients with schizophrenia, very few have focused on the diagnosis of dementia.
  
  
  OBJECTIVE
  Our objectives were to accurately diagnose dementia in a cohort of middle-aged patients with schizophrenia and to assess the type of dementia.
  
  
  METHODS
  96 patients with schizophrenia (46 inpatients and 50 outpatients), aged 50 to 70 years, underwent a psychiatric, neurological, and neuropsychological evaluation at baseline and after a 20-month follow-up. We established a 3-step procedure: 1) diagnose dementia according to the DSM-IV criteria, using the Mattis Dementia Rating and Activities of Daily Living scales; 2) characterize dementia using brain imaging, perfusion by 99mTc-ECD-SPECT and laboratory tests including Alzheimer's disease cerebrospinal fluid biomarkers; and 3) search for genetic determinants.
  
  
  RESULTS
  Fourteen patients fulfilled the diagnostic criteria of dementia. Four were diagnosed with possible or probable behavioral-variant frontotemporal dementia (bvFTD), two with probable Alzheimer's disease, two with probable vascular dementia (including one due to CADASIL), one with CNS inflammatory disease, and six could not be fully characterized.
  
  
  CONCLUSIONS
  The diagnosis of dementia in middle-aged patients with schizophrenia is challenging but possible, using a multistep procedure. The most frequent condition, bvFTD, could reflect the presence of an evolutive neurodegenerative process in some patients.
authors.affiliation: Department of Neurology, Rouen University Hospital, Rouen, France Deparment of Research, Rouvray Psychiatric Hospital, Sotteville-lès-Rouen, France Inserm, U1079, Rouen, France; University of Rouen, Normandie Univ, Institute for Research and Innovation in Biomedicine, Rouen, France CNR MAJ, Rouen, Lille and Paris Salpêtrière Hospitals, France.
authors.forename: Gaël
authors.initials: G
authors.lastname: Nicolas
authors.affiliation: Deparment of Research, Rouvray Psychiatric Hospital, Sotteville-lès-Rouen, France Inserm, U1079, Rouen, France; University of Rouen, Normandie Univ, Institute for Research and Innovation in Biomedicine, Rouen, France.
authors.forename: Laurène
authors.initials: L
authors.lastname: Beherec
authors.affiliation: Department of Neurology, Rouen University Hospital, Rouen, France Inserm, U1079, Rouen, France; University of Rouen, Normandie Univ, Institute for Research and Innovation in Biomedicine, Rouen, France CNR MAJ, Rouen, Lille and Paris Salpêtrière Hospitals, France.
authors.forename: Didier
authors.initials: D
authors.lastname: Hannequin
authors.affiliation: University Department of Psychiatry, Rouvray Psychiatric Hospital, Sotteville-Lès-Rouen, France.
authors.forename: Gaëlle
authors.initials: G
authors.lastname: Opolczynski
authors.affiliation: Inserm, U1079, Rouen, France; University of Rouen, Normandie Univ, Institute for Research and Innovation in Biomedicine, Rouen, France University Department of Psychiatry, Rouvray Psychiatric Hospital, Sotteville-Lès-Rouen, France.
authors.forename: Maud
authors.initials: M
authors.lastname: Rothärmel
authors.affiliation: Department of Neurology, Rouen University Hospital, Rouen, France Inserm, U1079, Rouen, France; University of Rouen, Normandie Univ, Institute for Research and Innovation in Biomedicine, Rouen, France CNR MAJ, Rouen, Lille and Paris Salpêtrière Hospitals, France.
authors.forename: David
authors.initials: D
authors.lastname: Wallon
authors.affiliation: Department of Nuclear Medicine, Henri Becquerel Centre and Rouen University Hospital, Rouen, France.
authors.forename: Pierre
authors.initials: P
authors.lastname: Véra
authors.affiliation: Department of Neurology, Rouen University Hospital, Rouen, France CNR MAJ, Rouen, Lille and Paris Salpêtrière Hospitals, France.
authors.forename: Olivier
authors.initials: O
authors.lastname: Martinaud
authors.affiliation: Inserm, U1079, Rouen, France; University of Rouen, Normandie Univ, Institute for Research and Innovation in Biomedicine, Rouen, France University Department of Psychiatry, Rouvray Psychiatric Hospital, Sotteville-Lès-Rouen, France.
authors.forename: Olivier
authors.initials: O
authors.lastname: Guillin
authors.affiliation: Deparment of Research, Rouvray Psychiatric Hospital, Sotteville-lès-Rouen, France Inserm, U1079, Rouen, France; University of Rouen, Normandie Univ, Institute for Research and Innovation in Biomedicine, Rouen, France CNR MAJ, Rouen, Lille and Paris Salpêtrière Hospitals, France.
authors.forename: Dominique
authors.initials: D
authors.lastname: Campion
mesh_terms: D000368:Aged; D015331:Cohort Studies; D003704:Dementia / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D012559:Schizophrenia / Q000175:diagnosis* / Q000453:epidemiology; D012565:Schizophrenic Psychology
keywords: Alzheimer's disease; Mattis Dementia Rating Scale; dementia; frontotemporal lobar degeneration; schizophrenia; vascular dementia