Schizophrenia late-life

Psychotic symptoms in late life (greater than 65 years of age) are generally a result of an ongoing chronic illness carried over from younger life however, a small percentage of patients develop psychotic symptoms de novo, defined as late-life schizophrenia. The 6-month prevalence rate of schizophrenia in the elderly is around 1%. However, other illnesses presenting with psychotic symptoms are common in this population, as approximately one-third of patients with Alzheimer s disease, Parkinson s disease, and vascular dementia experience psychotic symptoms. The majority of data for antipsychotic use in the elderly comes from experience treating these other disease states. 

Jeste, D., Lacro, J., Gilbert, P., Kline, J., 6c Kline, N. (1993). Treatment of late-life schizophrenia with neuroleptics. Schizophrenia Bulletin, 19, 817—830. 

Schizophrenia is a devastating iiiness crippiing virtuaiiy every aspect of an individuai s identity. Thus, it interferes with the ability to correctly interpret perceptions, to relate appropriately to others on both a cognitive and an emotional basis, and to articulate one s thoughts clearly. Individuals with schizophrenia rarely achieve as much in life as their nonaffected age cohort. Before the discovery of antipsychotics, about 50% of hospital beds were occupied by these patients, and even now, they still occupy 25% of all beds. The disorder usually begins relatively early in life (i.e., late teens or early twenties) and rarely remits. It produces severe social deficits and at times chronic hospitalization for some. A substantial number of the homeless suffer from schizophrenia, as well as many who live isolated, unproductive lives in structured facilities. In summary, schizophrenia represents a tragedy for both patients and their families and is a major burden to society. 

Perhaps only few other disorders are as cruel as schizophrenia. Recent discoveries suggest that certain deficits, of a soft nature and usually not regarded as ominous by parents and close relations, are present during the developmental years of an individual marked to manifest schizophrenia later in life. But the illness takes its real bite just when the patient reaches late adolescence or early adulthood, as he or she prepares to enter the central stage of life, the years of productivity, independence, family building, and personal creativity. It destroys all dreams, and it truncates the development of new ones for the rest of the patient s existence. 

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