Zobrazit v EDS

Cognitive trajectories and dementia risk in patients with schizophrenia spectrum versus affective disorders

Uloženo v:
Podrobná bibliografie
Název: Cognitive trajectories and dementia risk in patients with schizophrenia spectrum versus affective disorders
Autoři: Kathy Y. Liu, Gayan Perera, Robert Howard, Christoph Mueller
Zdroj: Liu, K Y, Perera, G, Howard, R & Mueller, C 2025, 'Cognitive trajectories and dementia risk in patients with schizophrenia spectrum versus affective disorders', Psychological Medicine, vol. 55, e286. https://doi.org/10.1017/S0033291725101864
Informace o vydavateli: Cambridge University Press (CUP), 2025.
Rok vydání: 2025
Témata: Male, Aged, 80 and over, Cognitive Dysfunction/epidemiology, Risk Factors, Schizophrenia/epidemiology, Dementia/epidemiology, Humans, Female, Mood Disorders/epidemiology, Middle Aged, Retrospective Studies, Aged
Popis: Background Schizophrenia spectrum disorders confer an increased and earlier dementia diagnosis risk, but the relative timing and course of cognitive decline compared to individuals with affective disorders is unclear. Methods This retrospective study used de-identified electronic patient records to compare cognitive trajectories from the first recorded MMSE, representing the earliest cognitive concerns in relation to a possible dementia syndrome, and subsequent dementia risk between patients with a schizophrenia spectrum and primary affective disorder diagnosis. Patients had at least two MMSE scores recorded at least 6 months apart. We examined annual MMSE change from the first recorded MMSE, dementia risk, dementia subtypes, and rates of dementia assessment and treatment. Results Compared to affective disorders (n = 2,264; 71.1 years), schizophrenia spectrum disorders (n = 1,217; 65.0 years) showed earlier initial MMSE scores (by 6.1 years, 95% CI = 5.2–7.0), earlier dementia diagnoses (by 2.3 years, 95% CI = 0.9–3.7) but lower dementia risk (adjusted HR = 0.81; 95% CI = 0.69–0.95). Cognitive decline rates and dementia subtype diagnoses did not differ between affective and schizophrenia spectrum disorders, but it took longer for schizophrenia spectrum disorder patients to receive a dementia diagnosis (5.6 vs. 4.4 years). Anti-dementia medication was less likely to be prescribed in patients with schizophrenia versus depression. Conclusions Cognitive concerns in older individuals with schizophrenia spectrum disorders arise from around 63 years and are associated with earlier dementia risk versus older individuals with affective disorders. Findings emphasize the importance of targeted dementia prevention and treatment strategies in these individuals and the need to reduce the existing inequity of access to dementia services.
Druh dokumentu: Article
Popis souboru: application/pdf
Jazyk: English
ISSN: 1469-8978
0033-2917
DOI: 10.1017/s0033291725101864
Přístupová URL adresa: https://kclpure.kcl.ac.uk/ws/files/352923900/Cognitive_trajectories_and_dementia_LIU_Publishedonline30September2025_GOLD_VoR_CC_BY_.pdf
Rights: CC BY
Přístupové číslo: edsair.doi.dedup.....a71b1b9efec1f8dc706282e5b2b8756f
Databáze: OpenAIRE
Popis
Abstrakt:Background Schizophrenia spectrum disorders confer an increased and earlier dementia diagnosis risk, but the relative timing and course of cognitive decline compared to individuals with affective disorders is unclear. Methods This retrospective study used de-identified electronic patient records to compare cognitive trajectories from the first recorded MMSE, representing the earliest cognitive concerns in relation to a possible dementia syndrome, and subsequent dementia risk between patients with a schizophrenia spectrum and primary affective disorder diagnosis. Patients had at least two MMSE scores recorded at least 6 months apart. We examined annual MMSE change from the first recorded MMSE, dementia risk, dementia subtypes, and rates of dementia assessment and treatment. Results Compared to affective disorders (n = 2,264; 71.1 years), schizophrenia spectrum disorders (n = 1,217; 65.0 years) showed earlier initial MMSE scores (by 6.1 years, 95% CI = 5.2–7.0), earlier dementia diagnoses (by 2.3 years, 95% CI = 0.9–3.7) but lower dementia risk (adjusted HR = 0.81; 95% CI = 0.69–0.95). Cognitive decline rates and dementia subtype diagnoses did not differ between affective and schizophrenia spectrum disorders, but it took longer for schizophrenia spectrum disorder patients to receive a dementia diagnosis (5.6 vs. 4.4 years). Anti-dementia medication was less likely to be prescribed in patients with schizophrenia versus depression. Conclusions Cognitive concerns in older individuals with schizophrenia spectrum disorders arise from around 63 years and are associated with earlier dementia risk versus older individuals with affective disorders. Findings emphasize the importance of targeted dementia prevention and treatment strategies in these individuals and the need to reduce the existing inequity of access to dementia services.
ISSN:14698978
00332917
DOI:10.1017/s0033291725101864