In psychiatry, such a disease as senile schizophrenia is the subject of heated discussions. The essence of the controversy is as follows. Some experts consider this form of the disease only a type of typical schizophrenia, which manifested itself at a later age. Others are convinced that senile schizophrenia is only a symptomatic manifestation of age-related organic changes that occur in the brain of older people.
Also, patients with schizophrenia are divided into two groups depending on when the disease began – directly in old age or it is a continuation of the disease that developed from a young age. According to statistics, in the vast majority of cases, the onset of the disease occurs at a young age, and only 1.6% of people develop schizophrenia for the first time after 60 years.
The specificity of the development of schizophrenia with a late-onset
The most aggressive is the disease that began at a young age. The senile form of schizophrenia is considered more “mild”, and it has its own characteristics.
- With a late-onset, schizophrenia is manifested by fewer negative signs and symptoms.
- Schizophrenia is much more common in older women than in men of the same age.
- Older people respond better to treatment, in particular to antipsychotic medications than younger people.
- In old age, the risk of developing visual hallucinations is higher.
- The likelihood of emotional and mental disorders in the elderly, on the contrary, is reduced.
Why does schizophrenia occur in old age?
Mental pathologies can develop against the background of somatic diseases, and excessive use of drugs with a psychoactive effect. The cause of psychopathologies can be psychosis, which has developed due to taking a large list of medications, Alzheimer’s disease, various types of dementia, and Parkinson’s disease.
The risk of developing mental pathologies in old age is higher, the more concomitant factors a patient has. There is a whole list of risk factors that increase the likelihood of the disease. These include:
- Age-related changes in the cerebral cortex (primarily in the frontal and temporal lobes);
- Neurochemical changes associated with aging;
- Reduced performance of the organs of vision, hearing, and smell;
- Violation of cognitive functions (memory, thinking, attention).
The more factors that affect the patient, the higher the chance of getting a diagnosis of late schizophrenia.
The symptoms of senile schizophrenia are easily confused with senile dementia. Therefore, you can not make a diagnosis based on your own observations, you need to seek help from a psychiatrist. Only an experienced doctor who knows the difference between schizophrenia and dementia, after a long observation of the patient, studying the anamnesis, differential diagnosis, will be able to determine whether these or other symptoms are signs of schizophrenia.
What are the symptoms of people with senile schizophrenia?
Symptoms of the disease may vary depending on its stage. The earliest symptoms include obsessive thoughts and actions (also called obsessions and compulsions). A person can for a long time, without noticing anyone around, perform some kind of repetitive, often absurd actions. For example, washing the same plate for the tenth time in a row, and laying out things on the table in a certain order. Or he is constantly haunted by recurring disturbing thoughts – that something bad will happen.
In addition to compulsions and obsessions, sudden onset phobias can be a sign of an incipient mental disorder. So-called obsessive fears of anything. It is characteristic that most often the behavior and emotions of an elderly person do not confirm this fear. A phobia in a grandmother or grandfather is expressed in the fact that they can talk for hours without emotion about what they are afraid of. At the same time, fears, as a rule, look ridiculous. For example, it could be a fear of numbers.
When older people develop late-onset schizophrenia, most often the changes in behavior become pronounced. The most common symptoms of senile schizophrenia are:
- Isolation, apathy, loss of interest in previous hobbies, and activities;
- The appearance of crazy ideas, misperception of events;
- Development of visual and auditory hallucinations;
- Obsessive fears, and ideas;
- Capriciousness, irritability;
- Aggressive behavior;
- Refusal to observe basic rules of hygiene.
Characteristically, female symptoms of senile schizophrenia may differ from male ones. For example, in older women, in addition to the above disorders, paranoia, persecution mania, and panic attacks often develop.
It is important for relatives to notice changes in the behavior of their elderly relative in time, not to write them off as senile whims, but to seek help from a psychiatrist as soon as possible.
Early detection of senile schizophrenia can help slow or even stop the progression of the disease. And this means avoiding the social isolation of an elderly person, maintaining normal relations with relatives, and quality of life.
Forms of schizophrenia in old age
There are several types of schizophrenia that an older person may experience.
Paranoid. Most often it occurs in young people after 25 years. But paranoid schizophrenia can also develop in old people suffering from 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, a person may suspect that they want to kill him or poison him. Or he thinks that aliens are watching him. Often, patients with this form of the disease develop delusions of grandeur. This is how Napoleons or Ivan the Terrible appear. An attempt to dissuade the patient only leads to retaliatory aggression. With hallucinations, people with paranoid schizophrenia hear voices, can follow their commands, and even talk to non-existent interlocutors.
Fur coat. Otherwise, it is called paroxysmal-progredient. In most cases, schizophrenia, which first manifested itself at a late age (45-70 years), is attributed to this type. Coat-like schizophrenia is characterized by an acute onset and manifests itself with symptoms such as hallucinatory syndrome, affective attacks, and paranoid disorders.
Recurrent. Its peculiarity is that the attacks of the disease occur sporadically. Women are more likely to suffer from recurrent schizophrenia. The main symptoms are manic and depressive syndromes, which each time manifest themselves in the same way and usually in the same order. There is also a sluggish form of schizophrenia, in which there are nervous breakdowns, apathy, and an abnormal reaction to ordinary things. But in old age this disease practically does not occur, so we will not dwell on it.
Diagnosis of schizophrenia
Diagnosing senile schizophrenia is harder than it looks. Since the symptoms may be vague or similar to those of other diseases, a comprehensive examination is required to make an accurate diagnosis. It may include an MRI of the brain, genetic studies, determination of the level of hormones in the blood, and a neurophysiological test for schizophrenia. Thanks to a comprehensive examination, the accuracy of diagnosis can reach 90%.
Features of the treatment of the elderly with schizophrenia
Treat senile schizophrenia with antipsychotic drugs. Depending on the stage of the disease, its form, and the characteristics of the course, the psychiatrist can prescribe both permanent and periodic medication. If the patient has symptoms of depression, antidepressants are prescribed along with antipsychotics.
Relatively recently, a method of treating schizophrenia with stem cells has appeared. But, unfortunately, in old age, the cells of the body are already poorly able to divide and recover, so this method is practically not used to treat the elderly.
In addition to drug treatment, elderly patients with schizophrenia should be provided with a proper and healthy diet, feasible physical activity, and regular psychological support. These can be both individual and group sessions with a psychologist or psychotherapist.
Many people neglect psychological help because they do not understand its value. In fact, the psychologist does a very important job – during the period of remission, he helps the patient to realize his illness, share real and imaginary images, normalize sleep, and adapt to society. During the sessions, the psychotherapist helps to develop a new tactic for relations between the patient and his family members, contributing to the formation of tolerance. All this contributes to a better quality of life and mitigation of the symptoms of the disease.
Drugs for the treatment of senile schizophrenia
Only a doctor can prescribe drugs, including those listed in this article. Self-medication is dangerous to health. What drugs are commonly used in the medical treatment of senile schizophrenia?
- Clopazalin. The drug is often prescribed to older people. It is not recommended for patients under 60 years of age. Against the background of taking clopazalin, the patient may have side effects in the form of changes in blood composition, and drowsiness.
- Risperidone. This antipsychotic drug is commonly used for fur-like schizophrenia.
- Quetiapine. It is considered one of the safest and most effective medicines. The dose is increased incrementally. If the patient follows the rules for taking the medicine, side effects are not observed.
- Aripiprazole. Another drug that is suitable for the elderly, has a minimum number of side effects.
It is absolutely impossible to prescribe, change the drug, increase or decrease the dose, or reduce or increase the duration of admission without a doctor’s prescription. This can lead to serious health consequences.
Schizophrenia is a serious disease in which self-medication is not acceptable.
It is important to understand that schizophrenia is a chronic disease that a person will have to live with for years. And taking medication will become mandatory throughout life.
How long do people live with senile schizophrenia?
After the diagnosis is made, the person himself and his relatives have a question – how long can you live with schizophrenia. According to statistics, the life expectancy of people suffering from this disease is about 9 years less than the rest. But life expectancy also depends on other factors:
- Whether there are other chronic diseases, at what stage;
- When the disease was discovered;
- How regularly the patient takes the treatment prescribed by the doctor;
- Whether he is socially adapted or lives in isolation.
There is a direct link between schizophrenia and shortened life span. However, with proper and timely treatment, it is possible to prolong the life of the patient as much as possible.
What conditions create an elderly person with schizophrenia?
Not only competent therapy 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.
Isolating from society is a bad idea, which only contributes to the progression of the disease. If possible, it is necessary to communicate with people and lead a life close to normal.
Healthy eating, sleeping habits, and sports can alleviate anxiety, phobias, and other symptoms of schizophrenia.
It is important to help the patient find something to their liking. Knitting, reading books, drawing – any hobby distracts from extraneous voices in the head, from obsessive thoughts and actions.
Alcohol, smoking, and drugs are incompatible with schizophrenia. They provoke aggression and are not combined with many drugs. It is important to protect the patient from any stressful situations. It is useful to create an atmosphere of calm, and relaxation with the help of good films, and soothing music. Meditation and yoga help to relax, and control your thoughts and emotions.
Senile schizophrenia is a disease that today cannot be cured once and for all. But following the doctor’s recommendations, you can maintain the quality of life of an aging patient at a very decent level.