Abstract
Given that psychotic symptoms are relatively common in the older adults and can accompany a variety of conditions, correctly identifying the etiology of psychosis in older patients is essential for developing the most effective treatment plan. Here we focus on the identification and management of late-onset schizophrenia and schizophrenia-like psychosis.
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References
Ostling S, Skoog I. Psychotic symptoms and paranoid ideation in a nondemented population-based sample of the very old. Arch Gen Psychiatry. 2002;59(1):53–9.
Champagne LL, et al. Psychosis in geropsychiatric inpatients with and without dementia. Int J Geriatr Psychiatry. 1996;11(6):523–7.
Burke WJ, Roccaforte WH, Wengel SP. Characteristics of elderly patients admitted for the first time to a psychiatric facility. J Geriatr Psychiatry Neurol. 1988;1(3):159–62.
Howard R, Rabins PV, Castle DJ. Late onset schizophrenia. Philadelphia: Wrightson Biomedical; 1999. p. 278.
Bleuler M. Die spatschizophrenen Krankheitsbilder. Fortschr Neurol Psychiatr. 1943;15:259–90.
Roth M, Morrissey JD. Problems in the diagnosis and classification of mental disorder in old age; with a study of case material. J Ment Sci. 1952;98(410):66–80.
Kay DW, Roth M. Environmental and hereditary factors in the schizophrenias of age (“late paraphrenia”) and their bearing on the general problem of causation in schizophrenia. J Ment Sci. 1961;107:649–86.
Howard R, et al. Late-onset schizophrenia and very-late-onset schizophrenia-like psychosis: an international consensus. The International Late-Onset Schizophrenia Group. Am J Psychiatry. 2000;157(2):172–8.
Keith SJ, Regier AM, Rae DS. Schizophrenic disorders. In: Robins LN, Regier DA, editors. Psychiatric disorders in America: the epidemiologic catchment area study. New York: Free Press; 1991. p. 449.
Meesters PD, et al. Schizophrenia spectrum disorders in later life: prevalence and distribution of age at onset and sex in a dutch catchment area. Am J Geriatr Psychiatry. 2012;20(1):18–28.
Harris MJ, Jeste DV. Late-onset schizophrenia: an overview. Schizophr Bull. 1988;14(1):39–55.
Copeland JR, et al. Alzheimer’s disease, other dementias, depression and pseudodementia: prevalence, incidence and three-year outcome in Liverpool. Br J Psychiatry. 1992;161:230–9.
Copeland JR, et al. Schizophrenia and delusional disorder in older age: community prevalence, incidence, comorbidity, and outcome. Schizophr Bull. 1998;24(1):153–61.
Castle DJ, Murray RM. The epidemiology of late-onset schizophrenia. Schizophr Bull. 1993;19(4):691–700.
Holden NL. Late paraphrenia or the paraphrenias? A descriptive study with a 10-year follow-up. Br J Psychiatry. 1987;150:635–9.
van Os J, et al. Increasing age is a risk factor for psychosis in the elderly. Soc Psychiatry Psychiatr Epidemiol. 1995;30(4):161–4.
Cervantes AN, Rabins PV, Slavney PR. Onset of schizophrenia at age 100. Psychosomatics. 2006;47(4):356–9.
Reeves RR, Brister JC. Psychosis in late life: emerging issues. J Psychosoc Nurs Ment Health Serv. 2008;46(11):45–52.
Palmer BW, McClure FS, Jeste DV. Schizophrenia in late life: findings challenge traditional concepts. Harv Rev Psychiatry. 2001;9(2):51–8.
Pearlson GD, et al. A chart review study of late-onset and early-onset schizophrenia. Am J Psychiatry. 1989;146(12):1568–74.
Jeste DV, et al. Clinical and neuropsychological characteristics of patients with late-onset schizophrenia. Am J Psychiatry. 1995;152(5):722–30.
Howard R, et al. A comparative study of 470 cases of early-onset and late-onset schizophrenia. Br J Psychiatry. 1993;163:352–7.
Almeida OP, et al. Psychotic states arising in late life (late paraphrenia) psychopathology and nosology. Br J Psychiatry. 1995;166(2):205–14.
Vahia IV, et al. Is late-onset schizophrenia a subtype of schizophrenia? Acta Psychiatr Scand. 2010;122(5):414–26.
Mason O, Stott J, Sweeting R. Dimensions of positive symptoms in late versus early onset psychosis. Int Psychogeriatr. 2013;25(2):320–7.
Huber G, Gross G, Schuttler R. Late schizophrenia (author’s transl). Arch Psychiatr Nervenkr. 1975;221(1):53–66.
Rabins PV, Lavrisha M. Long-term follow-up and phenomenologic differences distinguish among late-onset schizophrenia, late-life depression, and progressive dementia. Am J Geriatr Psychiatry. 2003;11(6):589–94.
Cooper AF. Deafness and psychiatric illness. Br J Psychiatry. 1976;129:216–26.
Howard R, Almeida O, Levy R. Phenomenology, demography and diagnosis in late paraphrenia. Psychol Med. 1994;24(2):397–410.
Herbert ME, Jacobson S. Late paraphrenia. Br J Psychiatry. 1967;113(498):461–9.
Howard R, et al. Permeable walls, floors, ceilings and doors. Partition delusions in late paraphrenia. Int J Geriatr Psychiatry. 1992;7(10):719–24.
Rabins P, Pauker S, Thomas J. Can schizophrenia begin after age 44? Compr Psychiatry. 1984;25(3):290–3.
Howard R, Levy R. Charles Bonnet syndrome plus: complex visual hallucinations of Charles Bonnet syndrome type in late paraphrenia. Int J Geriatr Psychiatry. 1994;9(5):399–404.
Angermeyer MC, Kuhn L. Gender differences in age at onset of schizophrenia. An overview. Eur Arch Psychiatry Neurol Sci. 1988;237(6):351–64.
Hambrecht M, et al. Transnational stability of gender differences in schizophrenia? An analysis based on the WHO study on determinants of outcome of severe mental disorders. Eur Arch Psychiatry Clin Neurosci. 1992;242(1):6–12.
Lohr JB, et al. Minor physical anomalies in older patients with late-onset schizophrenia, early-onset schizophrenia, depression, and Alzheimer’s disease. Am J Geriatr Psychiatry. 1997;5(4):318–23.
Castle DJ, et al. Schizophrenia with onset at the extremes of adult life. Int J Geriatr Psychiatry. 1997;12(7):712–7.
Barak Y, et al. Very late-onset schizophrenia-like psychosis: clinical and imaging characteristics in comparison with elderly patients with schizophrenia. J Nerv Ment Dis. 2002;190(11):733–6.
Howard RJ, et al. A controlled family study of late-onset non-affective psychosis (late paraphrenia). Br J Psychiatry. 1997;170:511–4.
Howard R, et al. Apolipoprotein e genotype and late paraphrenia. Int J Geriatr Psychiatry. 1995;10(2):147–50.
Purohit DP, et al. Alzheimer disease and related neurodegenerative diseases in elderly patients with schizophrenia: a postmortem neuropathologic study of 100 cases. Arch Gen Psychiatry. 1998;55(3):205–11.
Essali A, Ali G. Antipsychotic drug treatment for elderly people with late-onset schizophrenia. Cochrane Database Syst Rev. 2012;15(2):CD004162.
Sin Fai Lam CC, et al. Service and treatment engagement of people with very late-onset schizophrenia-like psychosis. BJPsych Bull. 2016;40(4):185–6.
Jeste DV, et al. Relationship of neuropsychological and MRI measures to age of onset of schizophrenia. Acta Psychiatr Scand. 1998;98(2):156–64.
Pearlson GD, et al. Quantitative D2 dopamine receptor PET and structural MRI changes in late-onset schizophrenia. Schizophr Bull. 1993;19(4):783–95.
Corey-Bloom J, et al. Quantitative magnetic resonance imaging of the brain in late-life schizophrenia. Am J Psychiatry. 1995;152(3):447–9.
Rabins PV, et al. MRI findings differentiate between late-onset schizophrenia and late-life mood disorder. Int J Geriatr Psychiatry. 2000;15(10):954–60.
Howard R, et al. Magnetic resonance imaging volumetric measurements of the superior temporal gyrus, hippocampus, parahippocampal gyrus, frontal and temporal lobes in late paraphrenia. Psychol Med. 1995;25(3):495–503.
Tonkonogy JM, Geller JL. Late-onset paranoid psychosis as a distinct clinicopathologic entity: magnetic resonance imaging data in elderly patients with paranoid psychosis of late onset and schizophrenia of early onset. Neuropsychiatry Neuropsychol Behav Neurol. 1999;12(4):230–5.
Howard R, et al. White matter signal hyperintensities in the brains of patients with late paraphrenia and the normal, community-living elderly. Biol Psychiatry. 1995;38(2):86–91.
Symonds LL, et al. Lack of clinically significant gross structural abnormalities in MRIs of older patients with schizophrenia and related psychoses. J Neuropsychiatry Clin Neurosci. 1997;9(2):251–8.
Jones DK, et al. A diffusion tensor magnetic resonance imaging study of frontal cortex connections in very-late-onset schizophrenia-like psychosis. Am J Geriatr Psychiatry. 2005;13(12):1092–9.
Sachdev P, et al. Regional cerebral blood flow in late-onset schizophrenia: a SPECT study using 99mTc-HMPAO. Schizophr Res. 1997;27(2–3):105–17.
Wake R, et al. Regional cerebral blood flow in late-onset schizophrenia: a SPECT study using 99mTc-ECD. Eur Arch Psychiatry Clin Neurosci. 2016;266(1):3–12.
Wium-Andersen MK, Ørsted DD, Nordestgaard BG. Elevated C-reactive protein associated with late- and very-late-onset schizophrenia in the general population: a prospective study. Schizophr Bull. 2014;40(5):1117–27.
Heaton R, et al. Neuropsychological deficits in schizophrenics. Relationship to age, chronicity, and dementia. Arch Gen Psychiatry. 1994;51(6):469–76.
Heaton RK, et al. Stability and course of neuropsychological deficits in schizophrenia. Arch Gen Psychiatry. 2001;58(1):24–32.
Brodaty H, et al. Long-term outcome of late-onset schizophrenia: 5-year follow-up study. Br J Psychiatry. 2003;183:213–9.
Schretlen DJ, et al. Neuropsychological functioning in bipolar disorder and schizophrenia. Biol Psychiatry. 2007;62(2):179–86.
Heinrichs RW, Zakzanis KK. Neurocognitive deficit in schizophrenia: a quantitative review of the evidence. Neuropsychology. 1998;12(3):426–45.
Brichant-Petitjean C, et al. Memory deficits in late-onset schizophrenia. Schizophr Res. 2013;151(1–3):85–90.
Hanssen M, et al. Comparative study of clinical and neuropsychological characteristics between early-, late and very-late-onset schizophrenia-spectrum disorders. Am J Geriatr Psychiatry. 2015;23(8):852–62.
Miller BL, et al. Brain lesions and cognitive function in late-life psychosis. Br J Psychiatry. 1991;158:76–82.
Almeida OP, et al. Cognitive features of psychotic states arising in late life (late paraphrenia). Psychol Med. 1995;25(4):685–98.
Laks J, et al. Absence of dementia in late-onset schizophrenia: a one year follow-up of a Brazilian case series. Arq Neuropsiquiatr. 2006;64(4):946–9.
Rajji TK, Mulsant BH. Nature and course of cognitive function in late-life schizophrenia: a systematic review. Schizophr Res. 2008;102(1–3):122–40.
Shah JN, et al. Is there evidence for late cognitive decline in chronic schizophrenia? Psychiatry Q. 2012;83(2):127–44.
Palmer BW, et al. Are late-onset schizophrenia spectrum disorders neurodegenerative conditions? Annual rates of change on two dementia measures. J Neuropsychiatry Clin Neurosci. 2003;15(1):45–52.
Kørner A, et al. Late and very-late first-contact schizophrenia and the risk of dementia--a nationwide register based study. Int J Geriatr Psychiatry. 2009;24(1):61–7.
Andreasen NC, et al. Correlational studies of the scale for the assessment of negative symptoms and the scale for the assessment of positive symptoms: an overview and update. Psychopathology. 1995;28(1):7–17.
Sheikh JI, Yesavage JA. Geriatric depression scale (GDS): recent evidence and development of a shorter version. Clin Gerontol. 1986;5(1–2):165–73.
Almeida OP, Almeida SA. Short versions of the geriatric depression scale: a study of their validity for the diagnosis of a major depressive episode according to ICD-10 and DSM-IV. Int J Geriatr Psychiatry. 1999;14(10):858–65.
Mitchell AJ, et al. Which version of the geriatric depression scale is most useful in medical settings and nursing homes? Diagnostic validity meta-analysis. Am J Geriatr Psychiatry. 2010;18(12):1066–77.
Fieldstone SC, et al. Validation of the 15-item geriatric depression scale for clinical use with young and middle-aged adults. J Int Neuropsychol Soc. 2010;16(S1):41.
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Vannorsdall, T.D., Schretlen, D.J. (2019). Late-Onset Schizophrenia. In: Ravdin, L.D., Katzen, H.L. (eds) Handbook on the Neuropsychology of Aging and Dementia. Clinical Handbooks in Neuropsychology. Springer, Cham. https://doi.org/10.1007/978-3-319-93497-6_42
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DOI: https://doi.org/10.1007/978-3-319-93497-6_42
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