ABSTRACT
As the absolute number of older adults will double in the Western world over the next two decades, there will be a corresponding growth in the number of older people with schizophrenia (Dickinson, Iannone, Wilk, & Gold, 2004; Jeste et al., 1999; Palmer, Heaton, & Jeste, 1999). The intersection of aging and schizophrenia has been the subject of a number of long-running controversies dating back to Kraepelin’s initial formulations of this disorder as a “dementia praecox”. However, with some notable exceptions, there had been relatively little empirical data about the phenomenology and treatment of late-life schizophrenia until recent decades. Neuropsychology has proven to be one of the key sciences in fostering better understanding how this illness changes across the lifespan, influences on its course, and interventions to optimize adaptation (Palmer & Savla, 2009). In the present chapter, we provide an overview of late-life schizophrenia. Although our emphasis is on the neuro-psychological aspects of schizophrenia and aging, our overview will also include discussion of the prevalence, course, and clinical characteristics of late-life schizophrenia. Essential questions that are addressed in this chapter are how common is late-life schizophrenia? What is the course of the illness into later life in terms of symptoms, neuropsychological and functional deficits? We then provide a practical overview for clinical neuropsychologists in assessing older adults with schizophrenia, addressing how evaluation can aid in differentiating between late-life schizophrenia and other geriatric psychiatric disorders that exhibit similar symptoms. Finally, we address the remediation of the cognitive and functional deficits in these patients.
