Current Concepts in the Diagnosis and Treatment of Schizophrenia in Later Life

Abstract

Caring for patients with schizophrenia in later life is emerging as a major concern as well as a challenge for practicing psychiatrists. The clinical presentation and course of this disorder in older patients differ from that of younger patients with unresolved cognitive and social issues often being prominent. It is hard to establish a definite age of onset for schizophrenia in later life. However, based on research evidence, symptomatology, brain imaging studies, family history, and cognitive issues observed in older patients with schizophrenia, the International Late-Onset Schizophrenia Group proposed to retain the term schizophrenia for both early (before age 40) and late-onset, but further divided the late-onset schizophrenia into late-onset (onset after age 40) and very-late-onset (onset after age 60). The group also proposed that patients with onset of schizophrenia after age 60 should be called as very-late-onset-schizophrenia-like psychosis. This paper is an attempt to share current concepts relative to diagnosis and treatment options, based on bio-psycho-social model, for patients with schizophrenia in later life.