Geriatric Schizophrenia: Treating Older Adults

  • I want to revisit the topic of schizophrenia in our older years. At the end of this SharePost, I'll link to detailed information on the topic.


    Most accounts define middle age as between 45 and 60. Does it get better as we move forward in our recovery? I'll be 47 in April so I hope it does. I'm on the cusp of middle age.


    One thing that determines how well a person will fare is how quickly he's treated after first exhibiting symptoms and whether he takes his medication every day as prescribed.


    From Psychiatric Services: "The number of persons aged 55 and older with a diagnosis of schizophrenia is projected to double over the next 20 years."

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    In a symposium, David P. Folsom, MD presented data that middle aged and older individuals with SZ "may commonly have comorbid medical problems (eg, arthritis, hypertension, diabetes) yet these individuals tend to underutilize primary care services."


    An estimate is that up to 0.5 percent of people older than age 65 have schizophrenia, a figure expected to rise greatly in the next 30 years. A minority of SZ patients see their symptoms first emerge after 65.


    The dose could decrease for older patients with schizophrenia, yet maintenance drug treatment is usually required. According to a study, "cognitive-behavior therapy and social skills training can improve functioning, disease management, and mood disorder symptoms in older patients with schizophrenia."


    We need to enlist healthcare providers to engage in stigma-busting by educating their communities. The good news is that "nearly one out of five patients experiences remission of symptoms" of their schizophrenia. According to Julie Loebach Wetherell, PhD and Dilip V. Jeste, MD, "The cognitive performance of older adults with schizophrenia tends to remain stable over time."


    The Geriatric Mental Health Foundation, a partnership of the American Association of Geriatric Psychiatry, has a fact sheet I link to below as well.

     

    Healthy Aging: Keeping Mentally Fit As You Age, details exactly how to keep up a sound mind in a healthy body as you get older.


    Techniques:


    Be physically active.


    It helps prevent bone density loss, maintain balance and ward off illnesses (like heart disease, stroke and some cancers).


    Regular physical activity can maintain and improve your memory and mental ability, prevent dementia including Alzheimer's disease, prevent and alleviate depression and improve energy levels.


    Keep your cholesterol levels low.


    A blood cholesterol level of lower than 200 mg/dL is considered healthy, 200-239 mg/dL is borderline high, and 240 mg/dL and above is high.


    Eat your vegetables, fruits, whole grains and nonfat dairy products.


    Monitor your medication use, taking note of certain precautions, because some memory loss and forms of dementia occur with harmful drug combinations or inappropriate drug use.


    Drink moderately and if you don't drink, don't start.


    Limit yourself to only one drink a day, if you are over 65 and do not have a drinking problem. One drink is 12 ounces of beer, 1.5 ounces of distilled spirits, or 5 ounces of wine.


  • Give up smoking.

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    Easily the best thing you can do even if it's the only you do just starting out.


    Other suggestions are to maintain a healthy weight, take care of your teeth, keep mentally fit and reduce stress, as well as to look on the bright side and stay connected spiritually.


    The last technique is to stay socially connected.


    Even experts in other fields outside of mental health warn isolating yourself can be more detrimental than smoking or obesity. So I wouldn't pooh-pooh joining a Senior Center or Friendship Club when you get older.


    I know that when I finally, totally, retire from work, I intend on volunteering my time, possibly as the leader of an English conversation group for new Americans.


    We don't get older: we get better.


    It is possible for those of us diagnosed with schizophrenia to live healthy, active lives long into our sunset years.


    Links:

     

    Geriatric Psychiatrist Locator

     

    American Association for Geriatric Psychiatry

     

    Geriatric Mental Health

     

    Schizophrenia in Late Life textbook

     

    Depp CA and Jeste DV (eds): Successful Cognitive and Emotional Aging. Washington, DC: American Psychiatric Press, Inc., 2009 (419 pages).

Published On: March 11, 2012