Etiology is seldom known. In later ages, symptom occurrence may be associated with sensory impairments and social isolation, although not with progressive dementia.
15 In several studies, when compared to patients with an earlier age onset, patients with late-age schizophrenic-like symptoms were more likely to be women, had higher functioning in areas of learning and abstraction, and required lower doses of neuroleptic medications.
16
Magnetic resonance imaging (MRI) examination of patients with late-age onsets of schizophrenia demonstrate either no increase in structural abnormalities, or larger thalami.
16 Paraphrenia is a term that has been used to describe an apparent form of schizophrenia with initial presentation in late life marked by hallucinations and delusions, but with less significant affective disturbance.
14 Due to ambiguity about the presentation and epidemiology of this later onset schizophrenia-like syndrome, an international group formed to review the literature agreed that diagnoses of late-onset (after age 40) and very-late-onset (after age 60) schizophrenia-like psychoses have “face validity and clinical utility.”
15 Like its earlier age counterpart, the very late age presentation of schizophrenia-like symptoms is presumed to represent a group of heterogeneous disorders, characterized by delusional thinking, hallucinations, variable degrees of social-environmental dysfunction, and some cognitive impairment; in contrast to early-age onset schizophrenia, late-age symptoms include a higher prevalence of visual hallucinations, and a lower rate of affective flattening and formal thought disorder.
15
Schizophrenia may be the most expensive psychiatric disorder.
17 In one community-based study, the health-related quality of life was worse in middle-aged and older persons with schizophrenia than it was for patients with acquired immunodeficiency syndrome.
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