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Am J Psychiatry 1996; 153:1274-1279
Copyright © 1996 by American Psychiatric Association
Cognitive functioning in late-life schizophrenia: a comparison of elderly schizophrenic patients and patients with Alzheimer's disease
M Davidson, P Harvey, KA Welsh, P Powchik, KM Putnam and RC Mohs
Department of Psychiatry, Mount Sinai School of Medicine, New York, NY 10029, USA.
OBJECTIVE: Previous studies have suggested that geriatric inpatients with
chronic schizophrenia manifest profound cognitive impairments. This study
investigated how these cognitive impairments resemble those seen in
degenerative dementing conditions. METHOD: The neuropsychological battery
of the Consortium to Establish a Registry for Alzheimer's Disease (CERAD),
widely used to characterize the cognitive deficits of patients with
Alzheimer's disease, was used to compare patterns of cognitive impairment
in 66 triads of subjects consisting of one elderly patient with Alzheimer's
disease, one elderly, institutionalized patient with chronic schizophrenia,
and one elderly, cognitively normal comparison subject who were matched on
age, gender, and education. For some analyses, the two groups of patients
were divided into subgroups according to the degree of their cognitive
impairment (mild, moderate, or severe) as determined by their scores on the
Mini-Mental State examination. RESULTS: Relative to the comparison
subjects, both groups of patients showed cognitive deficits on each of the
neuropsychological measures. The schizophrenic patients performed worse
than the patients with Alzheimer's disease on tests of naming and
constructional praxis but were less impaired on the test of delayed word
recall. These differences were consistent across all levels of severity of
globally measured cognitive impairment. CONCLUSIONS: Consistent with
earlier findings from postmortem studies, these findings suggest that major
differences exist in the neurobiologic mechanisms responsible for cognitive
impairment in schizophrenia and Alzheimer's disease. Effects directly
attributable to social and environmental differences between these two
groups of patients may also play a role.
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