Special ArticleSchizophrenia and Older Adults: An Overview: Directions for Research and Policy
Section snippets
An Emerging Crisis
A crisis has emerged in mental health care. It involves older persons with serious and persistent mental illness: those persons age 55 and over with longstanding illnesses such as schizophrenia, bipolar disorder, or chronic depressionβwho have been largely invisible to mental health researchers, providers, and policymakers. Approximately 2% of the population over age 54βabout 1 million personsβsuffers from chronic mental illness other than dementia.1., 2. Over the next 30 years, their number
Where Do We Find Aging Persons With Schizophrenia?
Although the Epidemiologic Catchment Area study found prevalence rates of schizophrenia of only 0.3% among persons age 65 and over, this study tended to undersample in areas where persons with mental illness may be concentrated.19 The actual prevalence rate is probably about 1%,2., 5. and about 85% are living in the community. There has been a dramatic decline in the number of persons with schizophrenia living in mental institutions, and the Omnibus Budget Reconciliation Act (OBRA) regulations
How Does Schizophrenia Change Over the Life-Course?
In this section, we summarize the research and clinical practice literature. Interpretation of the literature on aging and schizophrenia requires an appreciation of a biopsychosocial life-course perspective that integrates the changes that occur over a lifetime among schizophrenic persons with the normal changes of aging in neuroendocrine systems, cognition, physical health, coping, and adaptation.3., 24., 25. Also, it should be noted that a limitation of the extant literature is that many
Recommendations
In sum, because the number of older persons with schizophrenia will increase dramatically over the ensuing decades, policymakers must begin to reorder research and service priorities to anticipate this growth. Our overview of the status of older persons with schizophrenia reveals that in many instances there are appreciable alterations in psychopathology, neuropsychological status, social functioning, and health that distinguish them from younger persons with the disorder. Nevertheless, the
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Cited by (0)
The authors are members of the Group for the Advancement of Psychiatry, Committee on Aging.
We thank Dr. Dilip Jerte, Dr. M. Jackuelyn Harris, and Carole Lefkowitz for their assistance.