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Development of a Virtual Reality Assessment of Everyday Living Skills
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Computerized neurocognitive test performance in schizophrenia: a lifespan analysis.

Farzin Irani1, Colleen M Brensinger, Jan Richard

  • 1Department of Psychiatry, Neuropsychiatry Section, University of Pennsylvania, School of Medicine, Philadelphia, PA 19104, USA. firani@upenn.edu

The American Journal of Geriatric Psychiatry : Official Journal of the American Association for Geriatric Psychiatry
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Computerized neurocognitive batteries reveal stable cognitive dysfunction in schizophrenia patients across all ages. Older patients show slower working memory but faster emotion processing, with fewer differences from healthy individuals after age 60.

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Area of Science:

  • Neuroscience
  • Psychiatry
  • Cognitive Science

Background:

  • Computerized neurocognitive batteries (CNBs) are increasingly used in large-scale studies.
  • Previous research established construct validity in younger schizophrenia patients, but not in older individuals.
  • CNBs offer new variables to clarify age-associated cognitive impairment.

Purpose of the Study:

  • To clarify age-associated cognitive impairment in schizophrenia across the lifespan using CNBs.
  • To assess the feasibility and utility of CNBs in large schizophrenia cohorts.
  • To investigate differences in cognitive performance between patients with schizophrenia and healthy comparisons across different age groups.

Main Methods:

  • A computerized neurocognitive battery (CNB) was administered to 624 patients with schizophrenia and 624 healthy comparison (HC) subjects aged 16-75.
  • The CNB assessed abstraction, mental flexibility, attention, working memory, recognition memory, language, visuospatial, and emotion processing.
  • Linear mixed effects models analyzed accuracy, response time, and efficiency scores, stratified by age.

Main Results:

  • Significant interactions were found for diagnosis, cognitive domain, and age group across all outcome variables.
  • Schizophrenia patients generally performed worse than HC subjects, except in the oldest age group (60+).
  • Older patients exhibited reduced working memory efficiency due to slower speed, not accuracy, and faster emotion processing compared to younger patients.

Conclusions:

  • Computerized assessments are feasible for large schizophrenia cohorts.
  • Schizophrenia is associated with stable, generalized neurocognitive dysfunction across the lifespan.
  • Age-related patterns include speed-accuracy trade-offs in working memory and enhanced emotional processing speed in older patients.