COGNITIVE-FUNCTIONING IN CHRONICALLY HOSPITALIZED SCHIZOPHRENIC-PATIENTS - AGE-RELATED-CHANGES AND AGE DISORIENTATION AS A PREDICTOR OF IMPAIRMENT

Although schizophrenic patients manifest cognitive impairments, there is considerable variability across patients in the severity of this im pairment. Very chronic patients with a poor outcome, particularly geri atric patients, manifest the most severe impairments, which have often been characterized as resembling dementia. This study examined age-re lated changes in cognitive functioning in a sample of schizophrenic pa tients (n=393) ranging from 25 to 95 years of age, with a specific foc us on identifying aspects of performance that were impaired in the you ngest patients and preserved in the oldest patients. Age disorientatio n was examined hi detail because it was previously found to predict gl obal intellectual impairment in chronic patients. All 22 test items ch anged linearly over time (with age), with aspects of orientation, conc entration, and delayed recall most impaired in young patients and nami ng and sentence repetition most preserved in the oldest patients. Age disoriented patients had more severe cognitive impairments at each age and the age-related changes in global impairment were more severe for these patients. The prevalence of age disorientation was consistent w ith previous reports and a one-year retest of the sample found that ag e disorientation was extremely stable over time within patients. The t ypes of functions that are preserved in the oldest patients underscore previous findings of differences between geriatric schizophrenic pati ents and patients with degenerative diseases and the stability of age disorientation suggests that it is a trait of a subset of schizophreni c patients, those who appear to have the most severely declining cours e of illness.