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Ageing with schizophrenia: an update
Haley V Solomon1,2,3, Martina Sinopoli1,2,3, Lynn E DeLisi2,4
1Harvard South Shore Psychiatry Residency Program, Brockton, Massachusetts.
Current Opinion in Psychiatry
|February 3, 2021
Summary
Older adults with chronic schizophrenia show varied symptoms and outcomes. Treatment involves antipsychotics, dose reduction, and psychosocial interventions for improved quality of life.
Area of Science:
- Geriatric Psychiatry
- Schizophrenia Research
- Clinical Psychology
Background:
- The population of older adults with schizophrenia is growing.
- Schizophrenia presents heterogeneously in older individuals, impacting symptom severity, quality of life, and outcomes.
- While suicide rates are elevated compared to peers, excess mortality is primarily due to natural causes.
Purpose of the Study:
- To review current literature on clinical symptoms, functioning, outcomes, and treatments for elderly individuals with chronic schizophrenia.
- To address the increasing prevalence and unique challenges of schizophrenia in late life.
- To identify gaps in understanding predictors of recovery and optimal treatment strategies for this demographic.
Main Methods:
- Systematic literature review of recent research on older adults with chronic schizophrenia.
- Analysis of clinical symptoms, functional status, and treatment outcomes.
- Examination of the role of antipsychotics, dose adjustments, and psychosocial interventions.
Main Results:
- Older adults with schizophrenia exhibit diverse trajectories, including remission, persistent nonremission, and fluctuating symptoms.
- Depression is common; cognitive decline and reduced illness awareness significantly affect function and quality of life.
- Antipsychotics are crucial, with potential for dose reduction in stable patients; interdisciplinary and psychosocial approaches are vital adjunctive therapies.
Conclusions:
- Schizophrenia in late life is under-researched, with older patients often excluded from studies.
- Further research is needed to identify modifiable predictors of remission and recovery.
- Optimizing efficacious and safe treatment strategies for elderly schizophrenia patients requires dedicated investigation.
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