Cognitive functioning in late-life schizophrenia: Its importance and implications for overall outcome

Cognitive impairment is an intrinsic feature of schizophrenia and a discrim inating factor between patients who require high and low levels of communit y support Although it was long believed rh:rr positive and disorganized sym ptoms of schizophrenia "burned out" over time and only negative or deficit symptoms would be detected in late life, several recent studies have sugges ted that this conception is not fully accurate. However, patients who are u nable to care for themselves and suffer from deficits in adaptive life func tioning often have negative symptoms as well as severe cognitive impairment . The strong correlation with cognitive function, even when the severity of negative symptoms is considered, suggests that interventions aimed at impr ovement of adaptive outcome may be targeted at enhancement of cognition. Th ese interventions may include atypical neuroleptic medications and augmenta tion strategies directly targeting cognition with specific agents that may not affect the positive or negative symptoms of the illness.