Cognitive impairment and functional status in elderly institutionalized patients with schizophrenia

Objective The relationship of cognitive impairment to functional status in older adults with schizophrenia was investigated. Patients Ninety-three psy chiatric inpatients with schizophrenia between the ages of 65 and 88 years. Two subsets of this sample, consisting of 48 and 24 patients, were studied with a greater number of assessment instruments. Measures The Mini-Mental State Examination (MMSE) was used for brief assess ment of overall cognitive functioning, and the Psychogeriatric Dependency R ating Scale (PGDRS) was administered to assess functional status. The cogni tive test battery from the Consortium to Establish a Registry for Alzheimer 's Disease (CERAD) and/or an expanded neuropsychological battery, was given to a subset of the patients. Results In the overall sample, patients with greater global cognitive impai rment had higher levels of rated impairment on the individual items that co mprised the Orientation and Physical, but not Behavior, subscales of the PG DRS. Furthermore, in the two subsamples, specific neuropsychological measur es of problem-solving, word list learning, naming and constructional praxis were related to overall measures of outcome. Conclusions Neuropsychological deficit and psychosocial outcome are multi-d imensional entities that relate to one another in complex ways. Copyright ( C) 2001 John Wiley & Sons, Ltd.