International Psychogeriatrics

Table of Contents - 01 October 2011 - Volume 23, Issue 08  

Research Article

Late-onset-psychosis: cognition

Caroline Girarda1a2a3 c1, Martine Simarda1a2, Robert Noiseuxa3, Louis Laplantea1, Michel Dugasa4, François Rousseaua5, Nadine Gagnona5, François Primeaua3, Evelyn Kellera5 and Patrick J. Berniera6

a1 École de psychologie, Université Laval, Québec, Canada

a2 Centre de Recherche Université Laval-Robert-Giffard (CRULRG), Québec, Canada

a3 Centre Hospitalier affilié universitaire l'Hôtel-Dieu de Lévis, Lévis, Québec, Canada

a4 Centre Hospitalier Université Laval (CHUL), Québec, Canada

a5 Centre Hospitalier Robert-Giffard (CHRG), Québec, Canada

a6 Services gériatriques spécialisés de christ-Roi, Centre de santé et des services sociaux de la Vieille-Capitale, Québec, Canada

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.

(Received September 06 2010)

(Revised October 27 2010)

(Revised January 19 2011)

(Accepted January 23 2011)

(Online publication March 22 2011)

Key words:

Correspondence:

c1 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.

Related Content