Older patients with chronic schizophrenia were associated with higher levels of depression and poorer cognitive function. These findings were published in Neuropsychiatric Disease and Treatment.

Patients with (n=241) and without (n=156) schizophrenia who had been hospitalized long-term (≥1 year) at the Shanghai Mental Health Center were recruited for this cross-sectional study between 2020 and 2021. Participants were evaluated by the Geriatric Depression Scale (GDS), Mini Mental State Examination (MMSE), Montreal Cognitive Assessment Test (MoCA), Positive and Negative Syndrome Scale (PANSS), Activity of Daily Living (ADL), and by blood biochemistry.

Patients with schizophrenia had a higher prevalence of depression (48.5% vs 17.3%; c2, 52.964; P <.001).


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Among the schizophrenia cohort, those with and without depression were aged mean 66.10±5.636 and 66.64±5.578 years, and 53.8% and 56.5% were men, respectively. The cohort of patients with depression had fewer years of education (P =.009), less had hypertension (P =.045), more had apolipoprotein E2 or E4 (P =.040), and they scored lower on the MMSE (P <.001), MoCA (P <.001), PANSS (P <.001), and higher on GDS (P <.001) and ADL (P =.004) assessments.

A significant negative correlation was found between GDS score and disease course (r, -0.157; P =.006).

In 2 separate analyses, risk for depression among the schizophrenia cohort was associated with education (odds ratio [OR], 1.122; 95% CI, 1.034-1.218; P =.006) and hypertension (OR, 0.519; 95% CI 0.300-0.898; P =.019) in model 1 and education (OR, 1.131; 95% CI, 1.040-1.230; P =.004), PANSS score (OR, 1.018; 95% CI, 1.003-1.034; P =.021), and hypertension (OR, 0.564; 95% CI, 0.320-0.992; P =.047) in model 2.

Among the control cohort, depression was not associated with age (c2, 0.004; P =.949), education (c2, 0.188; P =.665), or gender (c2, 0.456; P =.665).

The results of this study may have been biased as some depressive symptoms among patients with schizophrenia may be a side effect of medication.

These data indicated that depression was a common symptom among older patients with chronic schizophrenia. The subset of patients with depression had poorer cognitive function and activities of daily living, indicating that interventions to reduce symptoms of depression may improve quality of life.

Reference

Chen Y, Li W. Prevalence, influencing factors, and cognitive characteristics of depressive symptoms in elderly patients with schizophrenia. Neuropsychiatr Dis Treat. 2021;17:3645-3654. doi:10.2147/NDT.S341297