Cognitive decline in late-life schizophrenia: A longitudinal study of geriatric chronically hospitalized patients
Cognitive decline in late-life schizophrenia: A longitudinal study of geriatric chronically hospitalized patients
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DOI：
10.1016/s0006-3223(98)00273-x
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发表时间：
1999-01-01
影响因子：
10.6
通讯作者：
Davis, KL
中科院分区：
文献类型：
--
作者：
Harvey, PD;Silverman, JM;Davis, KL
背景资料：老年精神分裂症患者的慢性制度化过程中表现出的认知和功能障碍，牵连在发病后的某个时间点下降。在这些患者的认知和功能状态的变化率尚未确定与纵向study.Methods：326名精神分裂症患者进入一个30个月的随访研究，两个单独的评估的患者。总体功能和认知状态用临床痴呆评定（CDR）进行索引。生存分析用于检查认知和功能状态的变化，包括受损程度较轻患者的恶化和受损程度较高患者的改善。约30%的基线评分在轻度受损范围内的患者表现出CDR评分恶化至2.0分（中度）或重度抑郁，而只有7%的样本在基线时得分较低，似乎改善了他们的功能。在基线评估的患者的几个特征预测认知和功能下降的风险增加，包括较低的教育水平，年龄较大，更严重的阳性symptoms.Conclusions：认知和功能下降可以检测到在一个子集的老年精神分裂症长期住院患者的短期随访。这种下降似乎分布在患者中，而不是由于存在进行性退行性痴呆症。以后的研究将不得不确定这种下降的原因，可能是基于本研究中确定的风险因素。生物精神病学1999;45：32-40（C）1999年生物精神病学学会。
Background: Geriatric schizophrenic patients with a chronic course of institutionalization manifest cognitive and functional impairments that implicate decline at some time point after the onset of illness. The rate of change in cognitive and functional status in these patients has not yet been identified with a longitudinal study.Methods: Three hundred and twenty-six schizophrenic patients entered a 30-month follow-up study with two separate assessments of the patients. Overall functional and cognitive status was indexed with the Clinical Dementia Rating (CDR). Survival analysis was used to examine changes in cognitive and functional status, including worsening for the less impaired patients and improvements on the part of more impaired patients.Results: Approximately 30% of the patients who had baseline scores in the less impaired range manifested a worsening of their CDR ratings to a score of 2.0 (moderate) or mope severe, whereas only 7% of the sample with lower scores at baseline appeared to improve in their functioning. Several characteristics of the patients at baseline assessment predicted increased risk for cognitive and functional decline, including lower levels of education, older age, and more severe positive symptoms.Conclusions: Cognitive and functional decline can be detected in a short-term follow-up in a subset of geriatric long-stay patients with schizophrenia. This decline appears distributed across patients and not due to the presence of progressive degenerative dementing conditions. Later research will have to identify the causes of this decline, possibly on the basis of the risk factors identified in this study. Biol Psychiatry 1999;45:32-40 (C) 1999 Society of Biological Psychiatry.