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Relationship to Age, Chronicity, and Dementia

Robert Heaton, PhD; Jane S. Paulsen, PhD; Lou Ann McAdams; Julie Kuck, MA; Sidney Zisook, MD; David Braff, MD; M. Jackuelyn Harris, MD; Dilip V. Jeste, MD

Arch Gen Psychiatry. 1994;51(6):469-476.

Abstract
Background
We sought to determine whether neuropsychological impairment in schizophrenia is related to current age, age at onset, or duration of illness, and whether the pattern of such impairment can be distinguished from that caused by progressive dementias of Alzheimer's type. We administered a comprehensive neuropsychological test battery to a normal control group (n=38), a group of ambulatory patients with Alzheimer's disease (n=42), and three ambulatory schizophrenic groups: early onset—young (n=85), early onset—old (n=35), and late onset (n=22). Tests were grouped and analyzed according to eight major ability areas, and published procedures were used to remove the expected effects of normal aging.

Results
The three schizophrenic groups were found to be neuropsychologically similar to one another and different from normal controls and patients with Alzheimer's disease. There were no significant differences among the schizophrenic groups in level or pattern of neuropsychological functioning. Patients with Alzheimer's disease demonstrated less efficient learning and particularly more rapid forgetting than did the other groups.

Conclusions
These findings suggest that neuropsychological impairment in schizophrenia is unrelated to current age, age at onset, or duration of illness. The study further suggests that the encephalopathy associated with schizophrenia is essentially nonprogressive and produces a pattern of deficits that is different from that seen in progressive cortical dementias.

Author Affiliations
From the Department of Psychiatry, University of California—San Diego.

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