SciELO - Scientific Electronic Library Online

vol.5 issue2Use of memory strategies among younger and older adults: Results from objective and subjective measuresVerbal fluency: Effect of time on item generation author indexsubject indexarticles search
Home Pagealphabetic serial listing  

Services on Demand




Related links


Dementia & Neuropsychologia

Print version ISSN 1980-5764

Dement. neuropsychol. vol.5 no.2 São Paulo Apr./June 2011 

Original Articles

Cognitive performance of long-term institutionalized elderly patients with schizophrenia: A case control study

Desempenho cognitivo em pacientes idosos com esquizofrenia: um estudo caso-controle

Alexandre Paim Diaz 1  

Monica Zavaloni Scalco 2  

Marcelo Libório Schwarzbold 3  

Douglas Affonso Formolo 4  

Alberto Stoppe Júnior 5  

1Núcleo de Pesquisas em Neurologia Experimental e Clínica (NUPNEC), Departamento de Clínica Médica, Universidade Federal de Santa Catarina, Florianópolis SC, Brazil and Instituto de Psiquiatria de Santa Catarina, São José SC, Brazil;

2Department of Psychiatry, University of Toronto and Whitby Mental Health Centre, Seniors Program, Canada.

3Núcleo de Pesquisas em Neurologia Experimental e Clínica (NUPNEC), Departamento de Clínica Médica, Universidade Federal de Santa Catarina, Florianópolis SC, Brazil.

4Núcleo de Pesquisas em Neurologia Experimental e Clínica (NUPNEC), Departamento de Clínica Médica, Universidade Federal de Santa Catarina, Florianópolis SC, Brazil.

5Ambulatório de Neuropsiquiatria Geriátrica, Universidade Federal de Santa Catarina, Florianópolis SC, Brazil.


Cognitive impairment is inherent to the ageing process. Several studies suggest that patients with late-life schizophrenia have more marked cognitive impairment.


The aim of this study was to compare the cognitive performance of elderly institutionalized patients with schizophrenia and institutionalized elderly control patients without neurological or psychiatric diseases, matched for age, educational level and institutionalization time.


The Cambridge Examination for Mental Disorders of the Elderly (CAMCOG) was used to test 10 institutionalized elderly patients with schizophrenia. Results were compared with those of 10 institutionalized control patients with history of Hansen's disease.


Patients with schizophrenia showed a worse performance in terms of total CAMCOG score and on its subtests of orientation, language, abstraction, and memory (p≤0.05). Patients with schizophrenia also disclosed a non-significant trend toward lower scores on the MMSE and on calculus.


Findings demonstrated that schizophrenia was associated to worse cognitive impairment in long-term institutionalized elderly patients compared with institutionalized patients without neurological or psychiatric diseases.

Key words: elderly; cognition; institutionalization; schizophrenia.


Prejuízo cognitivo é inerente ao processo de senescência. Estudos tem sugerido que pacientes idosos com esquizofrenia apresentam esse prejuízo de maneira mais acentuada.


O objetivo deste estudo foi comparar o desempenho cognitivo de pacientes idosos com esquizofrenia, institucionalizados, com indivíduos idosos, institucionalizados, sem doenças neurológicas ou psiquiátricas, pareados pela idade, escolaridade e tempo de institucionalização.


"Cambridge Examination for Mental Disorders of the Elderly" (CAMCOG) foi aplicado em 10 pacientes, institucionalizados, com esquizofrenia, cujo desempenho cognitivo foi comparado ao de 10 indivíduos, institucionalizados, com história de doença de Hansen.


Pacientes com esquizofrenia apresentaram um pior desempenho na pontuação total do CAMCOG e em seus subitens orientação, linguagem, abstração e memória (p≤0.05). Pacientes com esquizofrenia também apresentaram uma tendência, não significativa, para menor pontuação no MEEM e cálculo.


Nossos achados demonstram que a esquizofrenia está associada a piora do comprometimento cognitivo em pacientes idosos com institucionalização de longa permanência comparados a pacientes institucionalizados sem doenças neurológicas ou psiquiátricas.

Palavras-chave: idosos; cognição; institucionalização; esquizofrenia.

Texto completo disponível apenas em PDF.

Full text available only in PDF format.


Harvey PD, Leff J, Trieman N, Anderson J, Davidson M. Cognitive impairment in geriatric chronic schizophrenic patients: a cross-national study in New York and London. Int J Geriatr Psychiatry 1997;12:1001-1007. [ Links ]

Sharma T, Antonova L. Cognitive function in schizophrenia. Deficits, functional consequences, and future treatment. Psychiatr Clin North Am 2003;26:25-40. [ Links ]

Rajji TK, Mulsant BH. Nature and course of cognitive function in late-life schizophrenia: a systematic review. Schizophr Res 2008;102:122-140. [ Links ]

Galletly C. Recent advances in treating cognitive impairment in schizophrenia. Psychopharmacology (Berl) 2009;202:259-273. [ Links ]

Mohamed S, Rosenheck R, Swartz M, Stroup S, Lieberman JA, Keefe RS. Relationship of cognition and psychopathology to functional impairment in schizophrenia. Am J Psychiatry 2008;165:978-987. [ Links ]

Lysaker PH, Tsai J, Henninger LL, Vohs JL, Viverito K. Decrements in sustained attention across trials in a continuous performance test: associations with social functioning in schizophrenia. J Nerv Ment Dis 2010;198:154-158. [ Links ]

Addington J, Girard TA, Christensen BK, Addington D. Social cognition mediates illness-related and cognitive influences on social function in patients with schizophrenia-spectrum disorders. J Psychiatry Neurosci 2010;35:49-54. [ Links ]

Roth M, Tym E, Mountjoy CQ, et al. CAMDEX. A standardised instrument for the diagnosis of mental disorder in the elderly with special reference to the early detection of dementia. Br J Psychiatry 1986;149:698-709. [ Links ]

American Psychiatric Association. Diagnostic and statistical manual of mental disorders, 4th Edition, text revision. Washington, DC: American Psychiatric Association; 2000. [ Links ]

Folstein MF, Folstein SE, McHugh PR. "Mini-mental state": a practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 1975;12:189-198. [ Links ]

Bottino CMC, Scalco AZ, Ferreira RCR, Hototian SR, Scalco MZ. Validade e confiabilidade da versão brasileira do CAMDEX. Arq Neuropsiquiatr 2001;59(Suppl 3):S20. [ Links ]

Bozikas VP, Kosmidis MH, Kiosseoglou G, Karavatos A. Neuropsychological profile of cognitively impaired patients with schizophrenia. Compr Psychiatry 2006;47:136-143. [ Links ]

Wilk CM, Gold JM, McMahon RP, Humber K, Iannone VN, Buchanan RW. No, it is not possible to be schizophrenic yet neuropsychologically normal. Neuropsychology 2005;19:778-786. [ Links ]

Brucki SM, Nitrini R, Caramelli P, Bertolucci PH, Okamoto IH. [Suggestions for utilization of the mini-mental state examination in Brazil]. Arq Neuropsiquiatr 2003;61:777-781. [ Links ]

Laks J, Fontenelle LF, Chalita A, Mendlowicz MV. Absence of dementia in late-onset schizophrenia: a one year follow-up of a Brazilian case series. Arq Neuropsiquiatr 2006;64:946-949. [ Links ]

Teather LA, Magnusson JE, Chow CM, Wurtman RJ. Environmental conditions influence hippocampus-dependent behaviours and brain levels of amyloid precursor protein in rats. Eur J Neurosci 2002;16:2405-2415. [ Links ]

Torasdotter M, Metsis M, Henriksson BG, Winblad B, Mohammed AH. Environmental enrichment results in higher levels of nerve growth factor mRNA in the rat visual cortex and hippocampus. Behav Brain Res 1998;93:83-90. [ Links ]

Amador XF, Strauss DH, Yale SA, Gorman JM. Awareness of illness in schizophrenia. Schizophr Bull 1991;17:113-132. [ Links ]

Vega U, Silberman C, Laks J, Braga RJ, Burdick KE. Association of education and cognitive status in Brazilian elderly institutionalized patients with schizophrenia. Schizophr Res 2005;78:107-109. [ Links ]

Sacchetti E, Turrina C, Valsecchi P. Cerebrovascular accidents in elderly people treated with antipsychotic drugs: a systematic review. Drug Saf. 2010;33:273-288. [ Links ]

Covell NH, Jackson CT, Weissman EM. Health monitoring for patients who have schizophrenia. Summary of the Mount Sinai Conference recommendations. Postgrad Med 2006;Spec No:20-6. [ Links ]

Newcomer JW. Antipsychotic medications: metabolic and cardiovascular risk. J Clin Psychiatry. 2007;68(Suppl)4:8-13. [ Links ]

Kreyenbuhl J, Dickerson FB, Medoff DR, Brown CH, Goldberg RW, Fang L, et al. Extent and management of cardiovascular risk factors in patients with type 2 diabetes and serious mental illness. J Nerv Ment Dis 2006;194:404-410. [ Links ]

Dolder CR, Furtek K, Lacro JP, Jeste DV. Antihypertensive medication adherence and blood pressure control in patients with psychotic disorders compared to ersons without psychiatric illness. Psychosomatics 2005;46:135-141. [ Links ]

Bottiggi KA, Salazar JC, Yu L, Caban-Holt AM, Ryan M, Mendiondo MS, et al. Long-term cognitive impact of anticholinergic medications in older adults. Am J Geriatr Psychiatry. 2006;14:980-984. [ Links ]

Heinik J. Effects of trihexyphenidyl on MMSE and CAMCOG scores of medicated elderly patients with schizophrenia. Int Psychogeriatr. 1998;10:103-108. [ Links ]

Received: March 14, 2011; Accepted: May 15, 2011

Alexandre Paim Diaz - Instituto de Psiquiatria de Santa Catarina (IPQ/SC) - 88123-300 São José SC - Brazil. E-mail:

Disclosure: The authors reports no conflicts of interest.

Creative Commons License This is an open-access article distributed under the terms of the Creative Commons Attribution License