The neuropsychology and neurobiology of late-onset schizophrenia and very-late-onset schizophrenia-like psychosis: A critical review

Assche, Leen Van; Morrens, Manuel; Luyten, Patrick; Ven, Luc Van de; Vandenbulcke, Mathieu

doi:10.1016/j.neubiorev.2017.08.024

Cited by 52 publications

(53 citation statements)

References 119 publications

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“…As schizophrenia patients' longevity increases and because higher cognitive deficits increase the risk of dementia (Van Assche, Morrens, Luyten, Van de Ven, & Vandenbulcke, 2017), it is important to adapt remediation programs to the specificity of older patients. Improving cognition in these patients may have several benefits such as higher quality of life, autonomy and perhaps preventing from dementia.…”

Section: Discussionmentioning

confidence: 99%

Executive functions in schizophrenia aging: differential effects of age within specific executive functions

Thuaire

Rondepierre

Bacon

et al. 2018

French Journal of Psychiatry

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There are common cognitive and brain abnormalities in schizophrenia and healthy aging which may cumulate in schizophrenia aging. However, the course of executive deficits in late-life schizophrenia is still controversial as it remains unclear whether schizophrenia patients show accelerated aging. The use of specific models of executive functions might help to shed new lights on this issue. The aim of this study was then to determine how each of the four specific executive functions (shifting, updating, inhibition and access to long-term memory) is affected by aging in schizophrenia compared to healthy aging. 20 younger (age 18-34), 17 middle-aged (age 35-49) and 25 older (age 59-76) schizophrenia patients and 62 healthy comparison participants matched for gender, age and education performed a neurocognitive battery evaluating the four specific executive functions. Schizophrenia patients performed worse than comparison participants on shifting, updating and access, whereas inhibition appeared preserved. Age affected the four functions with increased degradation of shifting and access in schizophrenia patients, whereas updating and inhibition showed a normal decline with age. These results suggest a vulnerability of prefrontal and cingulate cortexes in schizophrenia aging. Moreover, as age affected the specific executive functions differently, remediation programs should be adapted to older patients. Models of specific executive functions are useful for understanding the complexity of cognition in schizophrenia and its course during later life so that healthcare can be adapted accordingly.

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Section: Discussionmentioning

confidence: 99%

Executive functions in schizophrenia aging: differential effects of age within specific executive functions

Thuaire

Rondepierre

Bacon

et al. 2018

French Journal of Psychiatry

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“…Interestingly, the onset of both delusions and hallucinations in late life reflects disturbances in the frontal-subcortical-temporal brain systems transdiagnostically (Holt & Albert, 2006). Indeed, schizophrenia-like illnesses in late life are associated with increased ventricle-to-brain ratio (VBR), white matter (WM) pathology as well as functional and structural abnormalities in the frontal, subcortical and temporal brain regions compared to normally aging individuals (Van Assche et al, 2017). Additionally, frontotemporal abnormalities in the most frequently occurring neurodegenerative conditions in late life such as AD or DLB with psychotic symptoms also supersede those observed in AD or DLB without such symptoms (Jellinger, 2012).…”

Section: Neurobiological and (Neuro)psychological Underpinnings Of Lamentioning

confidence: 99%

“…The first onset of psychosis in late life is more common than previously assumed (Fischer & Aguera-Ortiz, 2017), presenting in approximately 10 to 62% of nursing home residents, 5 to 15% of elderly psychiatric inpatients and 27% of psychiatric outpatients (Reinhardt & Cohen, 2015). Many of these older individuals exhibit psychosis as a prodromal symptom to dementia (Kørner, Lopez, Lauritzen, Andersen, & Kessing, 2009;Savva et al, 2009), often associated with Alzheimer's type Dementia (AD) or Dementia with Lewy Bodies (DLB) (Van Assche, Morrens, Luyten, Van de Ven, & Vandenbulcke, 2017). However, in more than half of these cases, there is a non-progressive mild cognitive deficit (Brodaty, Sachdev, Koschera, Monk, & Cullen, 2003).…”

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confidence: 99%

The Neuropsychological Profile and Phenomenology of Late Onset Psychosis: A Cross-sectional Study on the Differential Diagnosis of Very-Late-Onset Schizophrenia-Like Psychosis, Dementia with Lewy Bodies and Alzheimer’s Type Dementia with Psychosis

Assche

Aubel

Ven

et al. 2018

Archives of Clinical Neuropsychology

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“…Accordingly, Brodaty suggests LOS predicts dementia in half of the cases [44]. Progressive cognitive decline seems to be related with stress-related accelerated brain aging rather than a neurodegenerative pathology [45].…”

Section: Clinical Picturementioning

confidence: 99%

Late-onset schizophrenia: from Manfred Bleuler to the present

Dias-Amaral¹,

Peixoto²,

Silva³

et al. 2018

IJCNMH

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Background: For Bleuler, late-onset schizophrenia (LOS) was characterized by onset after age 40, symptoms similar to the classic form and absence of signs of organic brain disease. We aim to describe the current aetiology, diagnosis and treatment of LOS, emphasizing the differences between LOS and classic schizophrenia.Methods: Non-systematic review of original articles and systematic reviews regarding late-onset schizophrenia aetiology, diagnosis and treatment indexed to Pubmed, ISI -Web of Knowledge, Scopus and EBSCO published between January 1980 and December 2017, using the MeSH query: schizophrenia AND late onset disorders. Altogether, 62 articles were deemed relevant by two independent reviewers and included in the final selection.Results: 23% of the cases of schizophrenia have late-(> 40 years) or very late-onset (> 60 years), with higher incidence in females. Genetic factors, menopause, sensory deficits, vascular and neurodegenerative lesions, and age per se are risk factors. Higher educational levels and marital rates and greater cognitive reserve stand out. Well systematized persecutory and jealousy delusions and auditory hallucinations are common. On the contrary, negative symptoms are uncommon. Cognitive functions are well preserved in the first year, but high rates of dementia are described after fiveyear follow-up. Due to the protective effect of oestrogen, LOS appears to have a worse prognosis in postmenopausal women. Despite the anti-psychotic drugs available, most patients remain symptomatic. Conclusion:There is a significant overlap between early-onset schizophrenia and LOS/very-late onset schizophrenia-like psychosis (VLOSLP), but there are important differences mainly regarding risk factors and symptoms that cannot be overlooked. Seventy-five years after the first description, it is necessary to better define LOS/VLOSLP as a debate identity.

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The neuropsychology and neurobiology of late-onset schizophrenia and very-late-onset schizophrenia-like psychosis: A critical review

Cited by 52 publications

References 119 publications

Executive functions in schizophrenia aging: differential effects of age within specific executive functions

Executive functions in schizophrenia aging: differential effects of age within specific executive functions

The Neuropsychological Profile and Phenomenology of Late Onset Psychosis: A Cross-sectional Study on the Differential Diagnosis of Very-Late-Onset Schizophrenia-Like Psychosis, Dementia with Lewy Bodies and Alzheimer’s Type Dementia with Psychosis

Late-onset schizophrenia: from Manfred Bleuler to the present

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