Late-onset Schizophrenia Group Research Articles

Investigation of alpha-synuclein in patients with late-onset schizophrenia

IntroductionThere is no consensus about whether late-onset schizophrenia(LOS) is a type of schizophrenia or a secondary psychotic disorder. One of the theories of the occurrence of late-onset psychoses is neurodegeneration caused by the imbalance of proteostasis.ObjectivesTo study the concentration and expression of alpha-synuclein in patients with LOS compared with controls.MethodsThe study involved 42 patients with the ICD-10 criteria of schizophrenia with the onset of the disease after 45 years and 104 controls with no dementia and severe somatic pathology, comparable in age and gender. The alpha-synuclein level was estimated in a lymphocytic cell fraction from patients with LOS N=42 and controls N=104 using the Human alpha-synuclein ELISA kit. The expression of the SNCA gene was studied in 22 LOS patients and 22 controls and determined by PCR using the SYBR Green Supermix kit and the CFX96 instrument in comparison with the referent genes using previously developed primers. LOS group underwent psychopathological examination including scales. Statistics: SPSS 12.0; the Mann–Whitney test; exponential regression analysis; data is given as median (min–max). The level of significance was set at p<0.05.ResultsThe alpha-synuclein level is higher in patients with LOS (9.21 (0.78-29.52)) compared to control (6,355 (0.46-35.44)), p=0.024. The mRNA level of the SNCA gene is higher in the LOS group (0.533 (0.089-1.406)) compared to controls (0.087 (0.016-0.266) , p<0.001.ConclusionsOur study shows the relationship of alpha-synuclein with the manifestations of LOS. Obtained novel data can open up new targets for therapy and bring it closer to understanding the phenomenon.DisclosureNo significant relationships.

A nationwide nested case-control study of new-onset obsessive-compulsive disorder following antipsychotics use in schizophrenia.

A substantial proportion of patients with schizophrenia suffer from comorbid obsessive-compulsive disorder (OCD) possibly associated with antipsychotics. However, little is known about the comparative risks of the antipsychotics. The present study aimed to investigate the risk of new-onset OCD following the initiation of different antipsychotic medications for schizophrenia relative to haloperidol. Using the Korean national claims data, patients aged 15-60years newly diagnosed with schizophrenia between 2010 and 2018 were identified. Of the 47,808 patients with schizophrenia treated with nine commonly prescribed antipsychotics, 775 new-onset OCD patients were matched to 3,100 patients without OCD using nested case-control design with 1:4 case-control matching based on the sex, age of index date, date of schizophrenia diagnosis, observation period, locations of medical institutions, and level of medical facilities. Using multivariable conditional logistic regression analysis, odd ratios (ORs) for new-onset OCD comparing each antipsychotic agent relative to haloperidol were computed. The risk for new-onset OCD during treatment with clozapine was significantly higher than that with haloperidol (adjusted OR 2.86; 95% confidence interval [1.63-5.03]). The risks for new-onset OCD with other antipsychotics were not significantly different from that with haloperidol.In subgroup analysis, the early and intermediate, but not late-onset schizophrenia group showed significant risk for OCD associated with clozapine use. The present findings, based on real-world national representative data, provide reliable evidence for the risk of new-onset OCD in patients with schizophrenia receiving clozapine at a population level.

Independent living skills and cognition in early-onset and late-onset of schizophrenia patients: a pilot study

Aim. To evaluate cognitive functions and independent living skills in patients with late-onset schizophrenia (LOS) compared to patients with early-onset schizophrenia (EOS).
 Methods. The study included two clinical groups: 8 EOS patients (M=51.37.2; 7 males) and 8 LOS patients (M=67.89.9; 8 females), with comparable illness duration (22.69.1 and 19.911.9 respectively). Cognitive functions were assessed through the Brief Assessment of Cognition in Schizophrenia (BACS). The Autonomy Assessment Scale (AS) was used to measure independent living skills. The MannWhitney U-test was applied to determine differences between groups.
 Results. LOS group performed significantly better on Digit Sequencing Task, Verbal Fluency and Tower Test of the BACS. Composite score on AS was also significantly better in LOS group along with better scores on AS`s subscales assessing primarily social skills.
 Conclusion. LOS patients have milder cognitive dysfunction along with better independent living and social skills compared to AOS patients.

The association between season of birth, age at onset, and clozapine use in schizophrenia.

This study aimed to determine whether the rate of clozapine use, an indicator of refractoriness in schizophrenia, is associated with the season of birth and age at onset in patients with schizophrenia based on nationwide data. Patients with schizophrenia (n=114749) who received prescriptions for antipsychotic medication between 2008 and 2014 were retrospectively identified from the Korean National Health Insurance Service database. The study population was divided into three groups based on their age at the onset of schizophrenia (early, middle, and late onset). We assessed differences in the month of birth between patients and the general population. In addition, the cumulative clozapine use was calculated. Compared to the late-onset schizophrenia group, the early- and middle-onset groups showed a higher probability of birth during the winter season. In addition, the early-onset group showed the highest cumulative clozapine use rate. In the middle-onset group, the initiation of clozapine use was significantly earlier for patients born in winter compared to those born in summer. Our results indicate that the age at onset is an important factor in predicting the prognosis of schizophrenia patients. The season of birth also affects the prognosis, but with less robustness. Specifically, it appears that early disease onset and winter birth might be associated with poor outcomes in Korean patients with schizophrenia.

Very late-onset schizophrenia-like psychosis: Case report and current status of the issue

IntroductionSchizophrenia has traditionally been considered to strictly be an early-onset disorder. Current nosologies, including DSMV, are not restrictive with age of onset in schizophrenia and all patients that satisfy diagnostic criteria fall into the same category. Since 1998, International Late-Onset Schizophrenia Group consensus, patients after 60 are classified as very-late onset schizophrenia-like psychosis. Female overrepresentation, low prevalence of formal thought disorder, and a higher prevalence of visual hallucinations are associated with later age at onset. Atypical antipsychotics represent the election treatment because of the reduced likelihood of EPS and tardive dyskinesias, and should be started at very low doses, with slow increases.ObjectiveTo review the current knowledge about very late-onset schizophrenia through systematic review of the literature and the analysis of a case.MethodsCase Report. Review. Literature sources were obtained through electronic search in PubMed database of last fifteen years.ResultsWe present a case of a 86-year-old woman suffering from delusions and hallucinations, diagnosed with very late-onset schizophrenia-like psychosis, after differential diagnosis with other disorders. We analyze ethiology, epidemiology, clinical features and treatment in geriatric patients with schizophrenia.ConclusionsReluctance to diagnose schizophrenia in old people is still present today, probably in relation with the inconsistency in diagnostic systems and nomenclature, and consideration of medical conditions in the diagnosis. Identification of these patients is really important in order to start an appropriate treatment, which can lead to patient clinical stability.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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

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.

The Abandoned Illness: where is the voice of the older adults?

British Journal of Mental Health NursingVol. 2, No. 1 CommentThe Abandoned Illness: where is the voice of the older adults?Elizabeth Collier, Sue EdwardsElizabeth CollierSearch for more papers by this author, Sue EdwardsSearch for more papers by this authorElizabeth Collier; Sue EdwardsPublished Online:9 Oct 2014https://doi.org/10.12968/bjmh.2013.2.1.15AboutSectionsView articleView Full TextPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareShare onFacebookTwitterLinked InEmail View articleReferencesBlakemore S (2012) Independent inquiry outlines failings in schizophrenia care. Mental Health Practice 16(4): 6–7 Crossref, Google ScholarBrewin CR (2007) Remembering and forgetting. In: Friedman MJKeane TMResick PAeds. (2007) Handbook of PTSD: Science and Practice. Guildford Press, London: 116–34 Google ScholarBytheway B, Ward R, Holland C, Peace S (2007) Too Old. Older People Accounts of Discrimination, Exclusion and Rejection. A Report from the Research on Age Discrimination Project (RoAD) to Help the Aged. Help the Aged, London Google ScholarCohen CL, Vahia L, Reyes P et al. (2008) Schizophrenia in later life. Clinical symptoms and social well-being. Psychiatric Services 59(3): 232–34 Crossref, Google ScholarCollier E, Sorrell J (2011) Schizophrenia in older adults. J Psychosoc Nurs Ment Health Serv 49(11): 17–21 Crossref, Google ScholarDepartment of Health (2011) No Health Without Mental Health. Department of Health, London Google ScholarHoward R, Rabins PV, Seeman MV, Jeste DV (2000) Late-onset schizophrenia and very-late-onset schizophrenia-like psychosis: an international consensus. The International Late-Onset Schizophrenia Group. Am J Psychiatry 157(2): 172–178 Crossref, Google ScholarJoseph Rowntree Foundation (2011) Older People with High Support Needs: How Can We Empower Them to Enjoy a Better Life. Joseph Rowntree Foundation, London Google ScholarReeves RR, Brister JC (2008) Psychosis in late life. Emerging issues. J Psychosoc Nurs Ment Health Serv 46(11): 45–52 Crossref, Google ScholarRoyal College of Psychiatrists (2009) Age Discrimination in Mental Health Services: Making Equality a Reality. Position Statement. PS2/2009. Royal College of Psychiatrists, London Google ScholarThe Schizophrenia Commission (2012) The Abandoned Illness: A Report from the Schizophrenia Commission. Rethink Mental Illness, London Google Scholar FiguresReferencesRelatedDetailsCited byA Literature Review on the Experience of Long-Term Mental Illness13 February 2018 | Issues in Mental Health Nursing, Vol. 39, No. 6Growing older with post-traumatic stress disorder12 May 2016 | Journal of Psychiatric and Mental Health Nursing, Vol. 23, No. 3-4 14 March 2013Volume 2Issue 1ISSN (print): 2049-5919ISSN (online): 2052-496X Metrics History Published online 9 October 2014 Published in print 14 March 2013 Information© MA Healthcare LimitedPDF download

The Abandoned Illness: where is the voice of the older adults?

British Journal of Mental Health NursingVol. 2, No. 1 CommentThe Abandoned Illness: where is the voice of the older adults?Elizabeth Collier, Sue EdwardsElizabeth CollierSearch for more papers by this author, Sue EdwardsSearch for more papers by this authorElizabeth Collier; Sue EdwardsPublished Online:9 Oct 2014https://doi.org/10.12968/bjmh.2013.2.1.15AboutSectionsView articleView Full TextPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareShare onFacebookTwitterLinked InEmail View articleReferencesBlakemore S (2012) Independent inquiry outlines failings in schizophrenia care. Mental Health Practice 16(4): 6–7 Crossref, Google ScholarBrewin CR (2007) Remembering and forgetting. In: Friedman MJKeane TMResick PAeds. (2007) Handbook of PTSD: Science and Practice. Guildford Press, London: 116–34 Google ScholarBytheway B, Ward R, Holland C, Peace S (2007) Too Old. Older People Accounts of Discrimination, Exclusion and Rejection. A Report from the Research on Age Discrimination Project (RoAD) to Help the Aged. Help the Aged, London Google ScholarCohen CL, Vahia L, Reyes P et al. (2008) Schizophrenia in later life. Clinical symptoms and social well-being. Psychiatric Services 59(3): 232–34 Crossref, Google ScholarCollier E, Sorrell J (2011) Schizophrenia in older adults. J Psychosoc Nurs Ment Health Serv 49(11): 17–21 Crossref, Google ScholarDepartment of Health (2011) No Health Without Mental Health. Department of Health, London Google ScholarHoward R, Rabins PV, Seeman MV, Jeste DV (2000) Late-onset schizophrenia and very-late-onset schizophrenia-like psychosis: an international consensus. The International Late-Onset Schizophrenia Group. Am J Psychiatry 157(2): 172–178 Crossref, Google ScholarJoseph Rowntree Foundation (2011) Older People with High Support Needs: How Can We Empower Them to Enjoy a Better Life. Joseph Rowntree Foundation, London Google ScholarReeves RR, Brister JC (2008) Psychosis in late life. Emerging issues. J Psychosoc Nurs Ment Health Serv 46(11): 45–52 Crossref, Google ScholarRoyal College of Psychiatrists (2009) Age Discrimination in Mental Health Services: Making Equality a Reality. Position Statement. PS2/2009. Royal College of Psychiatrists, London Google ScholarThe Schizophrenia Commission (2012) The Abandoned Illness: A Report from the Schizophrenia Commission. Rethink Mental Illness, London Google Scholar FiguresReferencesRelatedDetailsCited byA Literature Review on the Experience of Long-Term Mental Illness13 February 2018 | Issues in Mental Health Nursing, Vol. 39, No. 6Growing older with post-traumatic stress disorder12 May 2016 | Journal of Psychiatric and Mental Health Nursing, Vol. 23, No. 3-4 14 March 2013Volume 2Issue 1ISSN (print): 2049-5919ISSN (online): 2052-496X Metrics History Published online 9 October 2014 Published in print 14 March 2013 Information© MA Healthcare LimitedPDF download

Dimensions of positive symptoms in late versus early onset psychosis

Casenote studies have characterized late onset schizophrenia (LOS) and related psychoses as somewhat different symptomatically from patients with an early onset schizophrenia (EOS). This study examined a range of phenomenological aspects of delusions and hallucinations as well as traditional symptom measures in both groups. 34 LOS and 235 EOS completed the Positive and Negative Syndrome Scale, the Psychotic Symptom Rating Scales, and the Beck Depression and Anxiety inventories. Subgroups experiencing delusions were compared matching for chronological age and gender, and also when matched for chronicity and gender. Delusions were very common at over 80% in both groups. LOS participants with delusions exhibited greater suspiciousness/paranoia, greater belief-conviction, and reduced insight when compared with the EOS group. These findings remained when matching for chronicity of illness, but disappeared when matching for chronological age. Hallucinations were surprisingly rarer in LOS (35%) than EOS (57%), with half the LOS group reporting whispers rather than clearly audible sounds. In general, anxiety, depression, and distress were as marked in LOS and EOS. Similarities between EOS and LOS far outweighed the differences across a range of symptoms and measures. Greater delusional conviction, paranoia, and poorer insight in LOS were associated with the later age of onset rather than relating to chronicity of illness. As belief-conviction in LOS was not associated with increased grandiosity, disorientation, or unusualness of thought content, as it was in EOS, delusional conviction may be determined somewhat differently later in life.

Elderly patients with very late-onset schizophrenia-like psychosis and early-onset schizophrenia: Cross-sectional and retrospective clinical findings

Objectives: The aim of this study was to characterize the symptoms at onset/past and current symptoms of patients with Very Late-Onset Schizophrenia-Like Psychosis (VLOSLP; first onset of psychotic symptoms at/or after 60 years old) with those of elderly patients diagnosed with schizophrenia before the age of 40 years old (Early-Onset Schizophrenia—EOS) in order to validate the clinical nosology proposed by the International Late-Onset Schizophrenia Group. Methods: This is a between-patient comparison study with retrospective and current data taken from an historical cohort that was conducted from May/2005 to August/2008. Seventeen VLOSLP and 17 EOS were included. Schizophrenia and schizophrenia-like psychotic disorders were initially diagnosed by board-certified psychiatrists with the Diagnostic and Statistical Manual Criteria at use at onset of the disorders. Patients’ symptoms were assessed with the Scale for the Assessment of Positive Symptoms (SAPS) and the Scale for the Assessment of Negative Symptoms (SANS). The general scores on the SAPS/SANS were the primary outcomes. Results: Both groups had hallucinations and delusions at onset of the disease, but the following symptoms were more present and severe in EOS than in VLOSLP: hallucinations (p = 0.001); assiduity loss (p p = 0.001), reference (p p = 0.001) delusions. VLOSLP had mostly persecutory delusions. At current evaluation (follow-up of cohort), most patients in the two groups presented residual symptoms of anhedonia and apathy, but EOS, presented more symptoms of friendship poverty (d = 1.42, large effect size) than VLOSLP. The neuroimaging studies (when available) at follow-up demonstrated greater vascular cerebral lesions/vulnerability in VLOSLP than in EOS patients. Conclusion: This study showed that both VLOSLP and EOS had positive and negative symptoms in the past/at onset of the disease, but they were more severe in EOS than in VLOSLP. However, the positive symptoms of both groups at follow-up of the cohort (current evaluation) responded relatively well to neuroleptics.

Clinical Characterization of Late- and Very Late-Onset First Psychotic Episode in Psychiatric Inpatients

The goals of this study were to investigate the prevalence and initial symptoms of the late-onset schizophrenia (LOS: >40 years) and very-late-onset schizophrenia-like psychosis (VLOSLP: >60 years) nosological groups proposed by the International Late-Onset Schizophrenia Group. This was a retrospective, cross-sectional, chart review study. The study was conducted at Centre Hospitalier Robert-Giffard (CHRG), Quebec City, Canada. The medical records of inpatients from the CHRG who presented with psychotic symptoms were analyzed. Positive and negative symptoms were scored using the SAPS and SANS. Groups' symptoms were compared using chi(2), Fisher's exact tests, t tests, and exact Mann-Whitney tests. An exact conditional logistic regression analysis was performed to determine which clinical characteristics were the most predictive of the groups' classification. Among the 1,767 unique, first-admission medical records reviewed, 23 (1.3%) inpatients developed their first psychotic symptoms at the age of 40-59 years old (LOS), and 13 (0.7%) at the age of 60 years and above (VLOSLP). LOS patients were more apathetic and presented more abnormal psychomotor activity than the VLOSLP. Persecutory delusions, auditory hallucinations, inappropriate social behavior, formal thought disorders and anhedonia were frequent in the two groups. A logistic regression model including psychomotor abnormalities was statistically relevant to predict the belonging to LOS group. LOS and VLOSLP are rare. Abnormal psychomotor activity can properly differentiate VLOSLP and LOS. The nosological model proposed by the International Late-Onset Schizophrenia Group is at least partially supported by the present data.

Focus on Geriatric Psychiatry: Schizophrenia in Later Life: Clinical Symptoms and Social Well-being

The number of persons aged 55 and older with a diagnosis of schizophrenia is projected to double over the next 20 years. A tripartite classification system of early-onset schizophrenia, late-onset schizophrenia, and very-late-onset schizophrenia-like psychosis has been proposed. This column reviews recent findings on the outcome and associated features of clinical symptom and social well-being categories for older adults with early-onset schizophrenia.

Focus on Geriatric Psychiatry: Schizophrenia in Later Life: Clinical Symptoms and Social Well-being

Focus on Geriatric Psychiatry: Schizophrenia in Later Life: Clinical Symptoms and Social Well-being

Mid-sagittal anatomy in late-onset schizophrenia.

Of the midline brain structures, abnormalities have been demonstrated in the corpus callosum and cerebellum in young schizophrenic patients. Whether similar abnormalities are also present in late-onset schizophrenia (LOS) is not known. The mid-sagittal cross-sectional areas of brain regions, in particular the corpus callosum and cerebellum, on magnetic resonance imaging were examined in a group of patients with late-onset schizophrenia (N = 25) and contrasted with two comparison groups - early-onset schizophrenia (EOS) (N = 24) and healthy volunteers (NC) (N = 30) matched for age and gender. While the mean corpus callosum area in the LOS group was smaller than in the EOS (by 10.2%) and NC (by 6.2%) groups, the three groups did not differ statistically in the corpus callosum area or the corpus callosum to cerebrum ratios. The cross-sectional cerebellar areas or the cerebellum: cerebrum ratios also did not differ across the groups. The brainstem was smaller in the schizophrenic groups because of smaller cross-sectional areas of the pons, a statistically significant difference which could not be accounted for by any gross lesions on visual inspection. We found no abnormality in the mid-sagittal area of the corpus callosum and cerebellum in our early- or late-onset schizophrenia subjects. The significance of the finding of a smaller pontine cross-sectional area is unclear and speculation on it awaits independent replication using a volumetric measure.

Regional cerebral blood flow in late-onset schizophrenia: a SPECT study using 99mTc-HMPAO

Functional neuroimaging studies have been performed in many young patients with schizophrenia, but late-onset schizophrenia (LOS) remains largely unexamined by these techniques. We predicted that LOS would demonstrate regional cerebral blood flow (rCBF) abnormalities similar to those seen in early-onset schizophrenia (EOS), but with a basis in demonstrable coarse brain disease. The subjects were 15 LOS and 7 EOS patients and 27 healthy controls. Each was given a detailed clinical and neuropsychological assessment and underwent MRI and Tc99m-HMPAO single photon emission computed tomography (SPECT) scans. The LOS subjects had a significantly lower cerebral hemispheric perfusion than controls, with a lower perfusion in the frontal and temporal lobes bilaterally. The LOS group also had significantly lower left-to-right hemisphere blood flow ratios. EOS subjects had a lower frontal perfusion than the controls, which was significant in the left frontal region. The temporal perfusion in the EOS subjects was greater than in the LOS group, and not different from the control subjects. Left temporal perfusion was the most discriminating variable between LOS and control subjects on logistic regression. Correlations of perfusion with MRI were generally low with the exception that the asymmetry indices were significantly correlated, and basal ganglia perfusion correlated with basal ganglia hyperintensities on MRI. The total cerebral perfusion index correlated significantly with the mini-mental state examination (MMSE) score, and the temporal lobe perfusion correlated with MMSE scores and some verbal memory measures. In the schizophrenic groups, perfusion correlated nonsignificantly with symptom profiles. We conclude that our findings of temporal and frontal rCBF abnormalities, especially on the left side, in LOS are similar to those reported in schizophrenia in general. The results do not provide evidence for coarse brain disease underlying the rCBF abnormalities in LOS, or support the specificity of these abnormalities for particular subsyndromes of schizophrenia.

Probable neuroleptic induced tardive dyskinesia in association with combined SSRI and risperidone treatment

The goals of this study were to investigate the prevalence and initial symptoms of the late-onset schizophrenia (LOS: >40 years) and very-late-onset schizophrenia-like psychosis (VLOSLP: >60 years) nosological groups proposed by the International Late-Onset Schizophrenia Group.This was a retrospective, cross-sectional, chart review study.The study was conducted at Centre Hospitalier Robert-Giffard (CHRG), Quebec City, Canada.The medical records of inpatients from the CHRG who presented with psychotic symptoms were analyzed.Positive and negative symptoms were scored using the SAPS and SANS. Groups' symptoms were compared using χ2, Fisher's exact tests, t tests, and exact Mann-Whitney tests. An exact conditional logistic regression analysis was performed to determine which clinical characteristics were the most predictive of the groups' classification.Among the 1,767 unique, first-admission medical records reviewed, 23 (1.3%) inpatients developed their first psychotic symptoms at the age of 40–59 years old (LOS), and 13 (0.7%) at the age of 60 years and above (VLOSLP). LOS patients were more apathetic and presented more abnormal psychomotor activity than the VLOSLP. Persecutory delusions, auditory hallucinations, inappropriate social behavior, formal thought disorders and anhedonia were frequent in the two groups. A logistic regression model including psychomotor abnormalities was statistically relevant to predict the belonging to LOS group.LOS and VLOSLP are rare. Abnormal psychomotor activity can properly differentiate VLOSLP and LOS. The nosological model proposed by the International Late-Onset Schizophrenia Group is at least partially supported by the present data.

Schizophrenic symptoms, tardive dyskinesia and its association with cognitive functioning

The goals of this study were to investigate the prevalence and initial symptoms of the late-onset schizophrenia (LOS: >40 years) and very-late-onset schizophrenia-like psychosis (VLOSLP: >60 years) nosological groups proposed by the International Late-Onset Schizophrenia Group.This was a retrospective, cross-sectional, chart review study.The study was conducted at Centre Hospitalier Robert-Giffard (CHRG), Quebec City, Canada.The medical records of inpatients from the CHRG who presented with psychotic symptoms were analyzed.Positive and negative symptoms were scored using the SAPS and SANS. Groups' symptoms were compared using χ2, Fisher's exact tests, t tests, and exact Mann-Whitney tests. An exact conditional logistic regression analysis was performed to determine which clinical characteristics were the most predictive of the groups' classification.Among the 1,767 unique, first-admission medical records reviewed, 23 (1.3%) inpatients developed their first psychotic symptoms at the age of 40–59 years old (LOS), and 13 (0.7%) at the age of 60 years and above (VLOSLP). LOS patients were more apathetic and presented more abnormal psychomotor activity than the VLOSLP. Persecutory delusions, auditory hallucinations, inappropriate social behavior, formal thought disorders and anhedonia were frequent in the two groups. A logistic regression model including psychomotor abnormalities was statistically relevant to predict the belonging to LOS group.LOS and VLOSLP are rare. Abnormal psychomotor activity can properly differentiate VLOSLP and LOS. The nosological model proposed by the International Late-Onset Schizophrenia Group is at least partially supported by the present data.