background Little is known about non-affective non-organic psychoses of higher ages. Few prospective studies have been carried out during the last 10 years to fill in existing gaps of knowledge.
aim The psite study is an ongoing crosssectional and longitudinal study that aims at a better understanding of the aetiology, phenomenology and prognosis of the psychoses of higher ages.
methods Forty patients with onset of psychotic symptoms after age 45 years (late onset psychosis, lop, n=18) or age 65 years (very late onset psychosis, vlop, n=22) and 44 healthy controls were tested with the camcog and their performance on the total scale and the subscales orientation, attention, memory, language comprehension, verbal fluency, abstract reasoning, visuoconstruction and ideational and ideomotor praxis were compared. The test performance of lop and vlop were compared directly with correction for age and duration of psychosis.
results Compared to healthy controls, patients on average performed significantly worse on mmse (mean: 28.2 versus 26.2, p < .001) and camcog total scores (94.6 versus 85.2, p < .001), including the subscales attention (p = .006), memory (p < .001), verbal fluency (p = .021), abstract reasoning (p < .001) and visuconstruction (p = .002). However, vlop outperform lop with regard to camcog total score (p = .015) and verbal fluency (p = .007) if differences in age and duration of psychosis are controlled for.
conclusion Late and very late onset psychosis share neurocognitive deficits in the realm of episodic memory, attention, executive functioning and verbal fluency. Yet, the cognitive deficits in vlop are somewhat milder and more likely to be related to age, which raises some doubts on whether they reflect shared pathophysiological processes with lop.