Absence of dementia in late-onset schizophrenia: a one year follow-up of a Brazilian case series / A esquizofrenia de início tardio não evolui para demência: acompanhamento de um ano de uma série brasileira de casos

BACKGROUND: Cognitive deficits of late-onset schizophrenia (LOS) patients have been reported as stable, although some prospective studies show that a sub-group develop a significant cognitive decline. Data on LOS from developing countries are scarce. OBJECTIVE: To evaluate the cognitive performance of Brazilian patients with LOS over the course of one year. METHOD: Thirteen LOS patients were evaluated at baseline and after one year with the Mini-Mental State Examination (MMSE), the CAMCOG, the Positive and Negative Symptoms Scale, the PfefferÆs Activities of Daily Living (ADL), and the Neuropsychiatric Inventory (NPI). RESULTS: Cognition and activities of daily living remained stable over the course of one year [baseline MMSE= 21.31 (4.87) and CAMCOG=80.31 (16.68); end-point MMSE=20.77 (3.86) and CAMCOG=82.92 (14.42) (Z=-0.831; p=0.40); baseline ADL=4.31 (5.65); end-point ADL= 5.92 (3.86) (Z=-0.831; p=0.40)]; end-point NPI=10.54 (10.69) (Z=-0.737; p=0.46]. CONCLUSION: Like patients from developed countries, Brazilian patients with LOS do not seem develop dementia, at least over the course of one year.

INTRODUÇÃO: Os déficits cognitivos em pacientes com esquizofrenia tardia têm sido relatados como estáveis, embora alguns estudos prospectivos demonstrem que um sub-grupo evolui com declínio cognitivo significativo. Os dados sobre esquizofrenia de início tardio são escassos nos países em desenvolvimento. OBJETIVO: Avaliar o desempenho cognitivo de pacientes brasileiros com esquizofrenia de início tardio ao longo de um ano. MÉTODO: Os pacientes com esquizofrenia de início tardio (n=13) foram avaliados inicialmente e após um ano com o Mini-Exame do Estado Mental (MMSE), o CAMCOG, a Escala de Sintomas Positivos e Negativos, a Escala de Atividades de Vida Diária de Pfeffer (ADL) e o Inventário Neuropsiquiátrico (NPI). RESULTADOS: A cognição e as atividades de vida diária permaneceram estáveis ao longo de um ano [inicial MMSE= 21,31 (4.87) e CAMCOG=80,31 (16,68); final MMSE=20,77 (3,86) e CAMCOG=82,92 (14,42) (Z=-0,831; p=0,40); inicial ADL=4,31 (5,65); final ADL=5,92 (3,86) (Z=-0,831; p=0,40); inicial NPI=13,92 (16,87); final NPI=10,54 (10,69) (Z=-0,737; p=0,46)]. CONCLUSÃO: Assim como os pacientes de países desenvolvidos, esquizofrênicos de início tardio no Brasil não evoluem para demência, ao menos ao longo de um ano.

Absence of dementia in late-onset schizophrenia: a one year follow-up of a Brazilian case series.

BACKGROUND: Cognitive deficits of late-onset schizophrenia (LOS) patients have been reported as stable, although some prospective studies show that a sub-group develop a significant cognitive decline. Data on LOS from developing countries are scarce. OBJECTIVE: To evaluate the cognitive performance of Brazilian patients with LOS over the course of one year. METHOD: Thirteen LOS patients were evaluated at baseline and after one year with the Mini-Mental State Examination (MMSE), the CAMCOG, the Positive and Negative Symptoms Scale, the Pfeffers Activities of Daily Living (ADL), and the Neuropsychiatric Inventory (NPI). RESULTS: Cognition and activities of daily living remained stable over the course of one year [baseline MMSE= 21.31 (4.87) and CAMCOG=80.31 (16.68); end-point MMSE=20.77 (3.86) and CAMCOG=82.92 (14.42) (Z=-0.831; p=0.40); baseline ADL=4.31 (5.65); end-point ADL= 5.92 (3.86) (Z=-0.831; p=0.40)]; end-point NPI=10.54 (10.69) (Z=-0.737; p=0.46]. CONCLUSION: Like patients from developed countries, Brazilian patients with LOS do not seem to develop dementia, at least over the course of one year.