Summary Cognitive deficits are common in schizophrenic patients and in geriatric schizophrenic patients more than half meet the criteria for dementia. The 'dementia' observed in elderly schizophrenic patients could be an outcome variable, but may be the result of institutionalization or accumulating drug treatment. In the last decade, more than 400 studies focused on the issue of dementia in elderly schizophrenics. Evidence from emerging data underlines the presence of severe cognitive impairments and its functional consequences. It may be tentatively concluded that deficits in vigilance and secondary verbal memory hinder instrumental role functioning in a manner similar to that encountered in demented subjects. However, pathological and biochemical markers of dementia are not conclusively demonstrated in elderly schizophrenics. The role of neuroleptics in the formation of neurofibrillary pathology and the effects of cognition enhancing drugs in schizophrenia need to be elicited in the coming years.