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Late-onset-psychosis: cognition

Published online by Cambridge University Press:  22 March 2011

Caroline Girard ,
Martine Simard ,
Robert Noiseux ,
Louis Laplante ,
Michel Dugas ,
François Rousseau ,
Nadine Gagnon ,
François Primeau ,
Evelyn Keller  and
Patrick J. Bernier
Caroline Girard*
Affiliation:
École de psychologie, Université Laval, Québec, Canada Centre de Recherche Université Laval-Robert-Giffard (CRULRG), Québec, Canada Centre Hospitalier affilié universitaire l'Hôtel-Dieu de Lévis, Lévis, Québec, Canada
Martine Simard
Affiliation:
École de psychologie, Université Laval, Québec, Canada Centre de Recherche Université Laval-Robert-Giffard (CRULRG), Québec, Canada
Robert Noiseux
Affiliation:
Centre Hospitalier affilié universitaire l'Hôtel-Dieu de Lévis, Lévis, Québec, Canada
Louis Laplante
Affiliation:
École de psychologie, Université Laval, Québec, Canada
Michel Dugas
Affiliation:
Centre Hospitalier Université Laval (CHUL), Québec, Canada
François Rousseau
Affiliation:
Centre Hospitalier Robert-Giffard (CHRG), Québec, Canada
Nadine Gagnon
Affiliation:
Centre Hospitalier Robert-Giffard (CHRG), Québec, Canada
François Primeau
Affiliation:
Centre Hospitalier affilié universitaire l'Hôtel-Dieu de Lévis, Lévis, Québec, Canada
Evelyn Keller
Affiliation:
Centre Hospitalier Robert-Giffard (CHRG), Québec, Canada
Patrick J. Bernier
Affiliation:
Services gériatriques spécialisés de christ-Roi, Centre de santé et des services sociaux de la Vieille-Capitale, Québec, Canada
*
Correspondence should be addressed to: Caroline Girard, Ph.D., School of psychology, Pavillon Félix-Antoine-Savard, 2325 rue des Bibliothèques, Laval University, Québec, Canada, G1V 0A6. Phone: +1 418 656 2131; Fax: +1 418 656 3646. Email: caroline.girard.6@ulaval.ca.
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Abstract

Background: The objectives of the study were to characterize and compare the cognitive profile and natural evolution of patients presenting late-onset psychotic symptoms (LOPS: onset ≥50 years old) to those of elderly patients (≥50 years old) with life-long/early-onset schizophrenia (EOS: onset <40 years old).

Methods: Neuropsychological profiles of 15 LOPS patients were compared to those of 17 elderly EOS patients and to those of two control groups (n = 11/group). The evolution of the two patient groups was compared using an independent diagnostic consensual procedure involving a geriatric psychiatry physician/clinician and a neuropsychologist blinded to the initial psychiatric diagnosis.

Results: EOS presented significant memory and executive impairments when compared to controls but there was no significant difference between LOPS and their controls when age and education were taken into account. However, a detailed inspection of normative data suggests more executive impairments in LOPS than in EOS. The clinical judgment of experts was in favour of significant cognitive deficits with or without dementia in most LOPS (82.3%–94.1%) and EOS (80.0%–93.3%) patients. Regarding evolution, mild cognitive impairment (MCI) and vascular cognitive impairment (VCI) were the most common clinical diagnoses made by geriatric psychiatry physicians/clinicians for the LOPS (40%). In addition, 20% of LOPS versus 5.9% of EOS patients met the diagnostic criteria for dementia by consensus of the experts. Cerebral abnormalities were confirmed (CT scan; SPECT) in 73.3% of LOPS patients.

Conclusion: The present results suggest cognitive deficits (mostly of executive functions) and vascular and neurodegenerative vulnerability in LOPS. Further studies with larger samples are needed to confirm the present findings.

Keywords

psychotic symptomsschizophrenialate-onsetneuropsychologycognitionprognosis
Type
Research Article
Information
International Psychogeriatrics , Volume 23 , Issue 8 , October 2011 , pp. 1301 - 1316
Copyright
Copyright © International Psychogeriatric Association 2011

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