The clinical basis of cognitive impairment in elderly patients with schizophrenia

What is it about?

It is not clear whether there is a progressive element to the cognitive impairment of schizophrenia. We have hypothesised that frontal lobe impairment may be the static genetic endophenotype and that there is a progressive temporal lobe component (J.F.W. Deakin et al., J Psychopharmacol, 1997; 11(2): 133-142). We have tested this hypothesis by characterising the cognitive impairment in demented (Mini-Mental State Examination < 23) and nondemented (MMSE < 24) elderly patients with schizophrenia (> 60 yrs; n = 37; illness onset < 45 yrs).

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Why is it important?

As we have previously reported, nondemented patients perform less well in recognising faces than they do in recognising words from previously presented lists in the Warrington Recognition Memory Test. In contrast, in patients with dementia, word recognition was as impaired as face recognition (subtest by diagnosis interaction; p = 0.02). In keeping with progressive temporal-lobe dysfunction, demented patients were impaired in design learning. However, they were not impaired in word-list or story-recall. Patients with schizophrenia and dementia were impaired on Stroop colour-word conflict compared to nondemented patients. The groups did not differ in positive or negative symptom severity.

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