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Schizophrenia with onset after age 50 years

2: Neurological, neuropsychological and MRI investigation

Published online by Cambridge University Press:  03 January 2018

Perminder Sachdev ,
Henry Brodaty ,
Noelene Rose  and
Stuart Cathcart
Perminder Sachdev*
Affiliation:
School of Psychiatry, University of New South Wales and Neuropsychiatric Instihrte. The Prince of Wales Hospital, Sydney
Henry Brodaty
Affiliation:
School of Psychiatry, University of New South Wales and Academic Department of Psychogeriatrics, The Prince of Wales Hospital, Sydney
Noelene Rose
Affiliation:
Formerly School of Psychiatry, University of New South Wales and The Prince of Wales Hospital, Sydney
Stuart Cathcart
Affiliation:
Formerly School of Psychiatry, University of New South Wales and Neuropsychiatric Institute, The Prince of Wales Hospital, Sydney
*
Dr P. S. Sachdev, NPI, The Prince of Wales Hospital, Randwick NSW 2031, Australia. Tel: +61-2-93823763; fax: +61-2-93823774; e-mail: [email protected]
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Abstract

Background

Late-onset schizophrenia (LOS) may have a basis in age-related coarse brain disease, but empirical support for this is conflicting.

Aims

Is LOS characterised by more neurological disease than early-onset schizophrenia (EOS)?

Method

DSM–III–R–defined LOS subjects (n=27) were compared with 30 EOS and 34 volunteer control subjects on neurological status, neuropsychological test performance and brain magnetic resonance imaging (MRI)

Results

LOS and EOS groups had more ‘soft’ neurological signs and drug-induced movement abnormalities, and performed more poorly on tests assessing speed of information processing, memory and frontal executive functioning. On MRI, the LOS and EOS groups had greater lateral ventricular size than the control group. The LOS subjects also had more signal hyperintensities in periventricular white matter and subcortical nuclei than controls.

Conclusions

LOS and EOS subjects were very similar on neuropsychological, neurological and structural neuroimaging parameters, except that there were more MRI periventricular hyperintensities in LOS subjects.

Type
Papers
Information
The British Journal of Psychiatry , Volume 175 , Issue 5 , November 1999 , pp. 416 - 421
Copyright
Copyright © 1999 The Royal College of Psychiatrists 

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Footnotes

†

See Part 1, pp. 410–415. this issue.

Declaration of interest

The study was supported by the National Hearth and Medical Research Council of Australia and The Rebecca Cooper Foundation.

References

Almeida, O. P., Howard, R., Levy, R., et al (1995) Psychotic states arising in late life (late paraphrenia). The role of risk factors. British Journal of Psychiatry, 166, 215–228.Google Scholar
American Psychiatric Association (1987) Diagnostic and Statistical Manual of Mental Disorders (3rd edn, revised) (DSM–III–R). Washington, DC: APA.Google Scholar
Andreasen, N. C. (1983) The Scale for the Assessment of Negative Symptoms (SANS). lowa City, LA: The University of lowa.Google Scholar
Andreasen, N. C. (1984) The Scale for the Assessment of Positive Symptoms (SAPS). lowa City, LA: The University of lowa.Google Scholar
Andreasen, N. C. Endiott, J., Spitzer, R. L., et al (1977) The family history method using diagnostic criteria. Archives of General Psychiatry. 34, 1229–1235.Google Scholar
Annett, M. (1970) A classification of hand preference by association analysis. British Journal of Psychology, 61, 303–321.Google Scholar
Benton, A. L. & Hamsher, K. de S. (1989) Multilingual Aphasia Examination. lowa City, LA: AJA Associates.Google Scholar
Berg, E. A. (1948) A simple objective test for measuring flexibility in thinking. Journal of General Psychology. 39, 15–22.Google Scholar
Congalton, A. A. (1969) Status ranking list of occupations in Australia. In Status and Prestige In Australia. Melbourne: F. W. Cheshire.Google Scholar
Cooper, A. F., Curry, A. R., Kay, D. W., et al (1974) Hearing loss in paranoid and affective psychoses of the elderly. Lancet, ii. 851–854.Google Scholar
Corey-Bloom, J., Jernigan, T., Archibald, S., et al (1995) Quantitative magnetic resonance imaging of the brain in late life schizophrenia. American Journal of Psychiatry. 152, 447–449.Google ScholarPubMed
Fazekas, F., Chawluk, J. B., Alavi, A., et al (1987) MR signal abnormalities at 1.5 T in Alzheimer's dementia and normal aging. American Journal of Neuroradiology. 8, 421–426.Google Scholar
Folstein, M. R., Folstein, S. E. & McHugh, P. R. (1978) “Mini-Mental State”: a practical method of grading the cognitive state of patients for the clinician. Journal of Psychiatric Research. 12, 189–198.Google Scholar
Hachinski, V. C., Liff, L. D., Zilkha, E., et al (1975) Cerebral blood flow in dementia. Archives of Neurology, 32, 632–637.Google Scholar
Heaton, R., Paulson, J. S., McAdams, L. A., et al (1994) Neuropsychological deficits in schizophrenics: relationship to age, chronicity, and dementia. Archives of General Psychiatry, 51, 469–476.Google Scholar
Henderson, S., Duncan-Jones, P., Byrne, D. G., et al (1980) Measuring social relationships: the Interview Schedule for Social Interaction. Psychological Medicine, 10, 723–734.Google Scholar
Howard, R., Förstl, H., Naguib, M., et al (1992) First-rank symptoms of Schneider in late paraphrenia. British Journal of Psychiatry, 160, 108–109.Google Scholar
Howard, R., & Levy, R. (1993) Personality structure in the paranoid psychoses of later life. European Psychiatry, 8, 59–66.Google Scholar
Howard, R., Cox, T., Almeida, O., et al (1995) White matter signal hyperintensities in the brains of patients with late paraphrenia and the normal, community-living elderly. Biological Psychiatry, 38, 86–91.Google Scholar
Jeste, D. V., Harris, M. J., Krull, A., et al (1995) Clinical and neuropsychological characteristics of patients with late-onset schizophrenia. American Journal of Psychiatry, 152, 722–730.Google ScholarPubMed
Katz, S. & Apkon, C. A. (1976) A measure of primary sociobiological functions. International Journal of Health Services, 6, 493–507.Google Scholar
Kay, D. W. K. & Roth, M. (1961) Environmental and hereditary factors in the schizophrenias of old age (“late paraphrenia”) and their bearing on the general problem of causation in schizophrenia. Journal of Mental Science, 107, 649–686.Google Scholar
Kay, D. W. K., Cooper, A. F., Garside, R. F., et al (1976) The differentiation of paranoid from affective psychoses by patients' premorbid characteristics. British Journal of Psychiatry. 129, 207–215.Google Scholar
Kertesz, A., Black, S. E., Tokar, G., et al (1988) Periventricular and subcortical hyperintensities on magnetic resonance imaging: “rims, caps and unidentified bright objects”. Neurology, 45, 404–408.Google Scholar
Lawton, M. P. & Brady, E. M. (1969) Assessment of older people: self-maintaining and instrumental activities of daily living. Gerontologist, 9, 179–186.Google Scholar
Lesser, L. M., Miller, B. L., Swartz, R., et al (1993) Brain imaging in late-life schizophrenia and related psychoses. Schizophrenia Bulletin, 19, 773–782.Google Scholar
Manschreck, T. C. (1986) Motor abnormalities in schizophrenia. In Handbook of Schizophrenia, Volume 1: The Neurology of Schizophrenia (eds Nasrallah, H. A. & Weinberger, D. R.), pp. 65–96. Amsterdam: Elsevier.Google Scholar
National Institute of Mental Health (1976) Abnormal Involuntary Movement Scale (AIMS). In ECDEU Assessment Manual for Psychopharmocology, Revised (ed. Guy, E.), pp. 534–537. Rockville, MD: National Institute for Mental Health.Google Scholar
Nelson, H. E. & Willison, J. R. (1991) The Revised National Adult Reading Test – Test Manual. Windsor: NFER-Nelson.Google Scholar
Pearlson, G. D., Kreger, L., Rabins, P. V., et al (1989) Late life onset schizophrenia: a chart review study. American Journal of Psychiatry, 146, 1568–1574.Google Scholar
Prager, S. & Jeste, D. V. (1994) Sensory impairment in late-life schizophrenia. Schizophrenia Bulletin, 19, 755–772.Google Scholar
Rossi, A., de Cataldo, S., Di Michele, V., et al (1990) Neurological soft signs in schizophrenia. British Journal of Psychiatry, 157, 735–739.Google Scholar
Roth, M. & Kay, D. W. K. (1998) Late paraphrenia: a variant of schizophrenia manifest in late life or an organic clinical syndrome. A review of recent evidence. International Journal of Geriatric Psychiatry, 13, 775–784.Google Scholar
Sachdev, P. (1994) A rating scale for drug-induced akathisia: development, reliability and validity. Biological Psychiatry. 35, 263–271.Google Scholar
Symonds, L. L., Olichney, J. M., Jernigan, T. L., et al (1997) Lack of significant gross structural abnormalities in MRIs of older patients with schizophrenia and related psychoses. Journal of Neuropsychiatry and Clinical Neumsciences, 9, 251–258.Google Scholar
Victoroff, J., Mack, W. J., Grafton, S. T., et al (1994) A method to improve interrater reliability of visual inspection of brain MRI scans in dementia. Neurology, 44, 2267–2276.Google Scholar
Wechsler, D. (1981) WAIS–R Manual. New York: Psychological Corporation.Google Scholar
Wechsler, D. (1987) The Wechsler Memory Scale – Revised. New York: Harcourt Brace Jovanovich/The Psychological Corporation.Google Scholar
Wechsler, D. (1991) Wechsler Intelligence Scale for Children (3rd edn). New York: Psychological Corporation.Google Scholar
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