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Cognitive impairment and functional status in elderly institutionalized patients with schizophrenia
M M Kurtz1, P J Moberg, L H Mozley
1Department of Psychiatry, University of Pennsylvania School of Medicine, Philadelphia, PA, USA. mkurtz@harhosp.org
Objective:
The relationship of cognitive impairment to functional status in older adults with schizophrenia was investigated.
Patients:
Ninety-three psychiatric inpatients with schizophrenia between the ages of 65 and 88 years. Two subsets of this sample, consisting of 48 and 24 patients, were studied with a greater number of assessment instruments.
Measures:
The Mini-Mental State Examination (MMSE) was used for brief assessment of overall cognitive functioning, and the Psychogeriatric Dependency Rating Scale (PGDRS) was administered to assess functional status. The cognitive test battery from the Consortium to Establish a Registry for Alzheimer's Disease (CERAD) and/or an expanded neuropsychological battery, was given to a subset of the patients.
Results:
In the overall sample, patients with greater global cognitive impairment had higher levels of rated impairment on the individual items that comprised the Orientation and Physical, but not Behavior, subscales of the PGDRS. Furthermore, in the two subsamples, specific neuropsychological measures of problem-solving, word list learning, naming and constructional praxis were related to overall measures of outcome.
Conclusions:
Neuropsychological deficit and psychosocial outcome are multi-dimensional entities that relate to one another in complex ways.