In psychiatry, such a disease as senile schizophrenia is the subject of heated debate. The essence of debates is the following. Some specialists consider this form of the disease to be only a variant of typical schizophrenia, which manifested at a late age. Others are convinced that senile schizophrenia is only a symptomatic manifestation of age-related organic changes in older adults’ brains.
Also, patients with schizophrenia are divided into two groups depending on when the illness began – directly in old age, or it is a continuation of an illness that developed from a young age. According to statistics, most cases begin at a young age, and only 1.6% of people develop schizophrenia for the first time after age 60.
Specifics of the development of schizophrenia with late onset
The most aggressive illness is considered to begin at a young age. The older form of schizophrenia is considered more “mild” and has characteristics.
- At a late onset, schizophrenia manifests with fewer negative signs and symptoms.
- Schizophrenia in older women is much more common than in men of the same age.
- Older adults respond better to treatment, particularly antipsychotic medications.
- Older adults are at higher risk of developing visual hallucinations.
- In contrast, older people are less likely to have emotional and cognitive problems.
Why can schizophrenia occur in adulthood?
Mental disorders can develop on the background of somatic diseases and excessive use of drugs with a psychoactive effect. The cause of psychopathology can be psychosis developed due to a large list of medications, Alzheimer’s disease, various types of dementia, and Parkinson’s disease.
The more comorbid factors a patient has, the greater the risk of developing mental disorders in old age. A whole list of risk factors increases the likelihood of disease. These include:
- Age-related changes in the cerebral cortex (primarily in the frontal and temporal lobes);
- Neurochemical changes due to aging;
- Reduced performance of the organs of sight, hearing, and smell;
- Impairment of cognitive functions (memory, thinking, attention).
The more factors affect the patient, the higher the chance of receiving a diagnosis of “late schizophrenia.”
It is easy to confuse senile schizophrenia with senile dementia by its symptoms. Therefore, one should not make a diagnosis based on one’s observations; one should seek help from a psychiatrist. Only an experienced doctor who knows the difference between schizophrenia and dementia, after long observation of the patient, studying the anamnesis, differential diagnosis can determine whether certain symptoms are signs of schizophrenia.
What symptoms can people have senile schizophrenia?
Signs of the disease may vary depending on the stage of the disease. The earliest symptoms include obsessive thoughts and actions (obsessions and compulsions). For a long time, a person may perform repetitive, often absurd actions without noticing anyone around, for example, washing the same plate for the tenth time in a row and arranging things on the table in a certain order. Or he is constantly haunted by recurrent anxious thoughts that something bad will happen.
In addition to compulsions and obsessions, sudden phobias signify a beginning mental disorder. Obsessive fears of anything are called obsessive phobias. Characteristically, most often, the behavior and emotions of the older person do not confirm this fear. A phobia in a grandmother or grandfather expresses itself in the fact that they can talk for hours about what they are afraid of without emotion. At the same time, the fears usually look ridiculous. For example, it may be fear of numbers.
See Also: Schizophrenia and Drugs
When older people develop late-onset schizophrenia, behavioral changes are most often pronounced. The most common symptoms of senile schizophrenia:
- Withdrawal, apathy, loss of interest in former hobbies and activities;
- delusions, misperception of events;
- development of visual and auditory hallucinations;
- obsessive fears, ideas;
- capriciousness, irritability;
- aggressive behavior;
- Refusal to follow basic rules of hygiene.
Characteristically, female symptoms of senile schizophrenia may differ from male symptoms. For example, in addition to the disorders mentioned earlier, older women more often develop paranoia, persecution mania, and panic attacks.
It is important for relatives to notice the changes in the behavior of their elderly relative in time, not to write them off as senile quirks, but as early as possible to seek help from a psychiatrist.
Detection of senile schizophrenia at an early stage will help slow or even stop the progression of the disease. It means avoiding the social isolation of the older person and preserving normal relationships with relatives and quality of life.
Types of schizophrenia in the elderly
There are several types of schizophrenia that an older person can experience.
- Paranoid. It occurs most often in young people after the age of 25. But paranoid schizophrenia can also develop in older people who have Alzheimer’s disease. The peculiarity of this form is that the symptoms increase gradually, relatively slowly. The most striking signs are hallucinations and delusions. For example, someone may suspect they want to kill or poison him. Or he thinks that aliens are watching him. It is not uncommon for patients with this disease to develop delusions of grandeur. It is how Napoleon or Ivan the Terrible appear. Attempts to dissuade the patient lead only to retaliatory aggression. In hallucinations, people with paranoid schizophrenia hear voices, may obey their commands, and even talk to non-existent interlocutors.
- Seizure-like. It is otherwise called seizure-progressive. In most cases, the schizophrenia that first manifested itself at a late age (45-70 years) is referred to as this type. Schizophrenia is characterized by an acute onset and manifests symptoms such as hallucinatory syndrome, fits of effect, and paranoid disorders.
- Recurrent. Its peculiarity is that the attacks of the disease occur episodically. Recurrent schizophrenia more often affects women. The main symptoms are manic and depressive syndromes, which manifest the same way every time, and usually in the same order.
There is also a passive type of schizophrenia, in which there are nervous breakdowns, apathy, and abnormal reactions to ordinary things. But at an advanced age, this disorder is almost non-existent, so we will not dwell on it.
Diagnosis of schizophrenia
Diagnosing senile schizophrenia is more difficult than it seems. Because symptoms may be vague or similar to other conditions, a comprehensive evaluation is needed to make an accurate diagnosis. It may include MRI scans of the brain, genetic testing, blood hormone levels, and a neurophysiological test for schizophrenia. Due to the complex examination, the accuracy of the diagnosis can be up to 90%.
Features of treatment for older people with schizophrenia
Treatment of senile schizophrenia is with the help of drugs-neuroleptics. Depending on the stage of the disease, its form, and the peculiarities of its course, the psychiatrist can prescribe both constant and periodic medication intake. If a patient has depression symptoms and neuroleptics, prescribe antidepressants.
A relatively recent method of treating schizophrenia with stem cells has appeared. But unfortunately, at an advanced age, the cells have a poor ability to divide and regenerate, so this method is practically not used for treating the elderly.
In addition to drug treatment, should provide elderly patients with schizophrenia with a proper and healthy diet, feasible physical activity, and regular psychological support. It can be either individual or group sessions with a psychologist or psychotherapist.
Many people neglect psychological help because they do not understand its importance. The psychologist does a very important job – in remission, he helps the patient be aware of his illness, separate images real and imaginary, normalize sleep, and adapt to society. During the sessions, the therapist helps to develop new tactics for relations between the patient and his family members and promotes tolerance. All this contributes to a better quality of life and alleviation of symptoms.
Drugs for treatment of senile schizophrenia
Only your doctor can prescribe medications, including those mentioned in this article. Self-medication is dangerous to your health. What medications are commonly used in the drug therapy of senile schizophrenia?
- Clopazalin. The drug is often prescribed to the elderly. Patients under the age of 60 are not recommended to take it. Against the background of taking Clopazalin, the patient may have side effects such as changes in blood composition and drowsiness.
- Risperidone. This drug with antipsychotic action is usually used in the schizophrenia coat form.
- Quetiapine. It is considered one of the safest and most effective drugs. The dose is increased in increasing increments. Side effects are not observed if the patient observes the drug’s rules.
- Aripiprazole. A minimal number of side effects characterizes another drug suitable for the elderly.
Prescribing, changing the drug, increasing or decreasing the dose, and reducing or increasing the duration of intake without a doctor’s appointment is categorically not allowed. It may lead to serious health consequences.
Schizophrenia – is a serious illness in which self-medication is not allowed.
It is important to understand that schizophrenia is a chronic disease with which a person will have to live for years. And taking medications will be mandatory for the rest of your life.
How long do people live with senile schizophrenia?
Once a person is diagnosed, the question for the person and their relatives is how long they can live with schizophrenia. According to statistics, life expectancy for people with the disease is about nine years shorter than for others. But life expectancy also depends on other factors:
- Whether there are other chronic illnesses, at what stage;
- When the disease was discovered;
- How regularly the patient takes the treatment prescribed by the doctor;
- Whether they are socially adapted or live in isolation.
There is a direct link between schizophrenia and reduced life expectancy. However, with proper and timely treatment, it is possible to maximize the patient’s life.
What conditions to provide for an older person with schizophrenia?
It is not only competent therapy that helps to slow down the course of the disease but also the support of loved ones, proper rehabilitation, and preventive measures.
- With the help of a psychologist and the support of loved ones, it is important to help the patient accept his diagnosis.
- Isolation from society – is a bad idea that only contributes to the progression of the disease. If possible, you must communicate with people and lead a lifestyle close to normal.
- A healthy diet, sleep patterns, and sports are good for relieving anxiety, phobias, and other symptoms of schizophrenia.
- It is important to help the patient find something to do. Knitting, reading books, drawing – any hobby distracts from extraneous voices in the head, from intrusive thoughts and actions.
- Alcohol, smoking, and drugs are incompatible with schizophrenia. They may provoke aggression and are not compatible with many medications.
- It is important to protect the patient from any stressful situations. It is useful to create an atmosphere of calmness and relaxation with the help of good movies and soothing music. Relaxing and controlling your thoughts and emotions helps with meditation and yoga.
Old age schizophrenia is an illness that cannot cure today once and for all. But by following the doctor’s recommendations, it is possible to maintain the quality of life of an aging patient at a very decent level.