Abstract
Recently emerging evidence indicates accelerated age-related changes in the structure and function of the brain in schizophrenia, raising a question about its potential consequences on cognitive function. Using a large sample of schizophrenia patients and controls and a battery of tasks across multiple cognitive domains, we examined whether patients show accelerated age-related decline in cognition and whether an age-related effect differ between females and males. We utilized data of 1,415 schizophrenia patients and 1,062 healthy community collected by the second phase of the Consortium on the Genetics of Schizophrenia (COGS-2). A battery of cognitive tasks included the Letter-Number Span Task, two forms of the Continuous Performance Test, the California Verbal Learning Test, Second Edition, the Penn Emotion Identification Test and the Penn Facial Memory Test. The effect of age and gender on cognitive performance was examined with a general linear model. We observed age-related changes on most cognitive measures, which was similar between males and females. Compared to controls, patients showed greater deterioration in performance on attention/vigilance and greater slowness of processing social information with increasing age. However, controls showed greater age-related changes in working memory and verbal memory compared to patients. Age-related changes (η2p of 0.001 to .008) were much smaller than between-group differences (η2p of 0.005 to .037). This study found that patients showed continued decline of cognition on some domains but stable impairment or even less decline on other domains with increasing age. These findings indicate that age-related changes in cognition in schizophrenia are subtle and not uniform across multiple cognitive domains.
Highlights
Using a large sample of schizophrenia patients and controls and a battery of tasks across multiple cognitive domains, we examined whether patients show accelerated age-related decline in cognition and whether an age-related effect differ between females and males
While schizophrenia is considered a neurodevelopmental disorder with fixed early deficits, emerging evidence supports the idea that schizophrenia patients may show both an early brain dysfunction along with progressive neural and/or behavioral deterioration over the course of the illness
Schizophrenia patients showed faster age-related deterioration in white matter integrity, emerging after age 35, and this deterioration was focused in the anterior corpus callosum and the temporal aspects of the superior longitudinal fasciculus, areas implicated in schizophrenia [2,3,4]
Summary
While schizophrenia is considered a neurodevelopmental disorder with fixed early deficits, emerging evidence supports the idea that schizophrenia patients may show both an early brain dysfunction along with progressive neural and/or behavioral deterioration over the course of the illness. Schizophrenia patients showed greater age-related reduction in the brain gray matter volumes than controls after early adulthood [1, 2]. This pattern was disproportionately greater in the clinically important frontal and temporal regions [2]. Patients showed greater age-related decline in functional connectivity in several neural networks including the frontal-parietal network and cingulo-opercular network compared with healthy control subjects (HCS) [7]. Existing evidence suggests that schizophrenia patients show faster age-related decline in the structure and function of the brain compared to healthy controls
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