Age-Associated Differences in Cognitive Performance in Older Patients With Schizophrenia: A Comparison With Healthy Older Adults
Age-Associated Differences in Cognitive Performance in Older Patients With Schizophrenia: A Comparison With Healthy Older Adults
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DOI：
10.1097/jgp.0b013e31823bc08c
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发表时间：
2012-01-01
影响因子：
7.2
通讯作者：
Harvey, Philip D.
中科院分区：
文献类型：
--
作者：
Loewenstein, David A.;Czaja, Sara J.;Harvey, Philip D.
背景：关于衰老和精神分裂症对认知能力的联合影响，有不同的结果。以前的研究受到精神分裂症和精神健康对照样本以及少量对照参与者的年龄范围限制。目的：量化精神分裂症患者和精神健康老年人对照组的年龄与认知能力之间的相关性，并确定两组认知能力的年龄相关变化是否不同。研究方法：精神分裂症患者（n = 226）和精神健康者（n = 834），年龄从40岁到80岁以上，进行了一系列神经心理学测试。为了直接比较年龄对认知表现的影响，年龄也对两个样本的表现进行了回归。结果如下：在工作记忆和情景记忆、执行功能和精神速度方面，70岁及以上精神健康成年人的表现上级最年轻的精神分裂症患者（40-49岁）。回归分析表明，年龄对认知的影响显着更大的精神分裂症患者的言语学习和处理速度的措施。在精神分裂症组和精神健康的成年人中，与年龄相关的最大表现差异似乎发生在70岁以上的个体中。结论：在这项横断面研究中，目前的研究结果强调了这样一个事实，即精神分裂症与所有年龄段的认知障碍有关，老年精神分裂症患者的认知功能与健康个体相比存在相对较大的年龄相关差异。这些发现对老年精神分裂症患者独立运作的能力和治疗策略的发展具有广泛的意义。(Am J Geriatr Psychiatry 2012; 20：29-40）
Background: There are varying results regarding the conjoint influence of aging and schizophrenia on cognitive abilities. Previous studies have been limited by restricted age ranges among schizophrenia and psychiatrically healthy control samples as well as small numbers of control participants. Objective: To quantify the association between age and cognitive performance in patients with schizophrenia and psychiatrically healthy older adult controls and to determine if age-associated changes in cognitive performance were different in the two groups. Methods: People with schizophrenia (n = 226) and psychiatrically healthy individuals (n = 834) ranging in age from 40 to older than 80 years were compared on a battery of neuropsychological tests. To directly compare the impact of age on cognitive performance, age was also regressed on performance in the two samples. Results: The performance of psychiatrically healthy adults age 70 and older was superior to the performance of the youngest patients with schizophrenia (age 40-49) years on measures of working and episodic memory, executive function, and psychomotor speed. Regression analyses indicated that age effects on cognition were significantly greater for schizophrenia patients on measures of verbal learning and speed of processing. Within both the schizophrenia group, and psychiatrically healthy adults, the greatest age-related differences in performance seemed to occur for individuals aged more than 70 years. Conclusion: In this cross-sectional study, the present findings underscore the fact that schizophrenia is associated with cognitive impairment across all ages and that older schizophrenia patients experience relatively greater age associated differences in cognitive functioning than healthy individuals. These findings have wide-ranging implications regarding the ability of older patients with schizophrenia to function independently and for the development of treatment strategies. (Am J Geriatr Psychiatry 2012; 20: 29-40)