Schizophrenia in Later Life: Understanding the Unique Challenges and Needs of Older Adults

Schizophrenia In Seniors

Schizophrenia is a mental health condition that affects millions of people around the world, including older adults. As individuals age, they become more susceptible to a range of health problems. Unfortunately, older adults with schizophrenia often face unique challenges that can make it difficult to receive an accurate diagnosis and effective treatment.

In this blog, we will explore the topic of schizophrenia in older adults, including its symptoms, diagnosis, and treatment options. By raising awareness of schizophrenia in older adults, we hope to promote understanding and empathy for those who are living with this challenging condition.

Whether you are an older adult with schizophrenia, a caregiver, or a concerned family member, this blog is for you. Join us as we delve into the complex and multifaceted world of schizophrenia in older adults.

Schizophrenia in Older Adults: What Is It?

Schizophrenia in older adults is a chronic and severe mental disorder that can occur in people over the age of 65. It is characterized by a distorted perception of reality and can cause a range of symptoms. It is less common in older adults than in younger individuals, but can present unique challenges due to the aging process and the presence of coexisting medical conditions. 

Schizophrenia in older adults may be associated with cognitive decline, memory loss, and a decline in functional abilities, which can make daily activities and self-care challenging. 

Diagnosing schizophrenia in older adults can be complicated due to the overlapping symptoms with age-related changes or other medical conditions. Therefore, it is important to seek professional help for any mental health concerns, regardless of age.

Schizophrenia Among Older Adults in the US (Statistics)

Schizophrenia is a relatively rare condition among older adults, but it can still affect a significant number of individuals in the US. According to the National Institute of Mental Health (NIMH), the prevalence of schizophrenia in individuals over the age of 65 is estimated to be between 0.1% and 0.5%. Because of that and given the aging population worldwide, the care of older adults with schizophrenia is emerging as a pressing public health concern. 

Research suggests that individuals with schizophrenia will make up 25% or more of all patients worldwide in the near future. Among those aged 60 and older with mental and substance use disorders, schizophrenia ranks as the third leading cause of disability-adjusted life years.

Despite the growing prevalence of schizophrenia in older adults, only a small percentage (around 1%) of the existing literature on schizophrenia focuses specifically on this population. However, the prevalence of schizophrenia in older adults is expected to double by 2025 and reach 1.1 million people in the US and 10 million people worldwide by 2050. This underscores the need for more research and policy attention to better understand and address the unique challenges faced by older adults with schizophrenia.

Characteristics of Schizophrenia

Schizophrenia in older adults can have some unique characteristics compared to the condition in younger individuals. Some of the common characteristics of schizophrenia in older adults include:

  • Late onset: Schizophrenia typically develops in the late teens or early twenties, but it can also develop later in life. In older adults, schizophrenia may have a later onset, with symptoms emerging for the first time after the age of 45.
  • Fewer positive symptoms: Positive symptoms of schizophrenia, such as delusions and hallucinations, tend to decrease in older adults with the condition. However, negative symptoms, such as social withdrawal and reduced emotional expression, may persist or worsen.
  • Cognitive decline: Older adults with schizophrenia may experience greater cognitive decline compared to those without the condition. This can affect their ability to perform daily tasks, make decisions, and maintain social relationships.
  • Comorbidities: Older adults with schizophrenia are at higher risk of developing comorbid medical conditions, such as diabetes and heart disease. They may also have higher rates of substance use disorders and depression.
  • Caregiver burden: Caring for an older adult with schizophrenia can be challenging and can lead to significant caregiver burden. This can affect the mental and physical health of the caregiver, as well as the quality of care provided to the individual with schizophrenia.
[NOTE: It is important for healthcare providers to be aware of these unique characteristics of schizophrenia in older adults in order to provide appropriate care and support.]


There is no one known cause of schizophrenia or the spectrum of diseases that it is associated with. A person’s chance of getting it is increased by several factors and situations, but none of them guarantees that you will.

Some of the potential causes of schizophrenia in older adults include:

  • Genetics: Schizophrenia tends to run in families, suggesting that genetics may play a role in the development of the condition. However, no single gene has been identified as the cause of schizophrenia.
  • Brain structure and function: People with schizophrenia often have differences in brain structure and function, including changes in brain volume and activity in certain areas of the brain.
  • Environmental factors: Exposure to certain environmental factors, such as infections, stress, and trauma, may increase the risk of developing schizophrenia.
  • Substance use: Substance use, particularly cannabis and amphetamines, has been linked to an increased risk of developing schizophrenia.
  • Aging: The aging process may contribute to changes in brain structure and function that increase the risk of developing schizophrenia later in life.
[QUICK FACT: It is important to note that schizophrenia is a complex condition, and the causes are likely to be multifactorial. Further research is needed to better understand the underlying causes of schizophrenia in older adults.]


Schizophrenia is a chronic and severe mental disorder that affects how a person thinks, feels, and behaves. The symptoms of schizophrenia can vary from person to person, and they can change over time. Here are some common symptoms of schizophrenia in older adults:

  1. Delusions – False beliefs that are not based in reality. For example, a person may believe that someone is trying to harm them, or that they have special powers or abilities.
  2. Hallucinations – Sensory experiences that are not based in reality. For example, a person may hear voices that are not there or see things that are not real.
  3. Disorganized speech – A person may have difficulty organizing their thoughts and communicating them clearly. They may speak in a way that is hard to understand, jump from topic to topic, or use made-up words.
  4. Disorganized behavior – A person may have difficulty with everyday activities such as hygiene, cooking, and cleaning. They may seem agitated, restless, or unable to sit still.
  5. Negative symptoms – A person may have a lack of motivation, emotion, or pleasure. They may have difficulty with everyday activities, such as socializing, and may seem to lack interest in life.
  6. Cognitive symptoms – A person may have difficulty with memory, attention, and decision-making. They may have trouble with problem-solving or planning.

Physical Health Issues Associated With Schizophrenia

Schizophrenia can also have a significant impact on a person’s physical health. Here are some physical health issues associated with schizophrenia:

  • Cardiovascular disease: People with schizophrenia are at an increased risk of developing cardiovascular disease due to lifestyle factors such as smoking, poor diet, and lack of physical activity. Antipsychotic medication can also cause weight gain and metabolic changes that increase the risk of heart disease.
  • Diabetes: People with schizophrenia are at an increased risk of developing type 2 diabetes due to the same lifestyle factors and medication effects as with cardiovascular disease.
  • Respiratory problems: Smoking is more common among people with schizophrenia, which can increase the risk of respiratory problems such as chronic obstructive pulmonary disease (COPD) and lung cancer.
  • Infectious diseases: People with schizophrenia may have a weakened immune system and be at an increased risk of developing infectious diseases such as pneumonia, influenza, and tuberculosis.
  • Dental problems: Poor oral hygiene and smoking can lead to dental problems such as gum disease and tooth decay.
  • Substance use disorders: Substance use disorders are common among people with schizophrenia, and can lead to a range of physical health problems.

It’s important for people with schizophrenia to receive regular physical health checkups and to work with their healthcare providers to manage any physical health issues that arise. A holistic approach that addresses both mental and physical health is essential for maintaining overall well-being.

Diagnosing Schizophrenia In Older Adults

Healthcare professionals can identify schizophrenia or related conditions by asking questions, listening to the patient describe their symptoms, and observing their behavior. To rule out other possible causes of the symptoms, they will also conduct additional tests and assessments. Then, they compare the results to the criteria required for a diagnosis of schizophrenia.

The Diagnostic and Statistical Manual of Mental Disorders-5 specifies that the following are necessary for a diagnosis of schizophrenia:

  • Two or more of the five primary symptoms: delusions, hallucinations, disorganized speech, disorganized or catatonic behavior, and negative symptoms.
  • Duration of symptoms: primary symptoms must persist for at least one month, and symptoms of the disorder must persist for at least six months.
  • Occupational or social dysfunction: the symptoms must interfere significantly with the individual’s ability to function at work or in social situations.

Treating Schizophrenia In Older Adults

Schizophrenia in older adults can be treated with a combination of medications, psychosocial interventions, and supportive care. Treatment plans should be tailored to the individual’s needs, taking into account their age, medical conditions, and cognitive functioning. 

Here are some common treatments for schizophrenia in older adults:

  • Antipsychotic medication: Antipsychotic medication is the mainstay of treatment for schizophrenia. Older adults may be more sensitive to the side effects of these medications, so dosages should be carefully monitored and adjusted as needed.
  • Psychosocial interventions: Psychosocial interventions can help older adults with schizophrenia manage their symptoms and improve their quality of life. These interventions may include individual therapy, family therapy, group therapy, and cognitive-behavioral therapy.
  • Supportive care: Supportive care, such as assistance with activities of daily living, can help older adults with schizophrenia maintain their independence and improve their quality of life.
  • Physical health management: As mentioned earlier, people with schizophrenia are at an increased risk of developing physical health problems such as cardiovascular disease and diabetes. Management of these conditions is an important part of treating schizophrenia in older adults.
  • Complementary therapies: Some older adults with schizophrenia may benefit from complementary therapies such as exercise, mindfulness meditation, or art therapy. These therapies can help reduce stress and improve overall well-being.

Treatment for schizophrenia in older adults may need to be adjusted as the person’s needs change over time. Regular monitoring and assessment of symptoms and treatment outcomes are essential for ensuring that treatment remains effective. With appropriate treatment and support, many older adults with schizophrenia can lead fulfilling and productive lives.

Prevention Strategies For Schizophrenia In Older Adults 

Regular exercise, healthy diet, and social support are important prevention strategies for schizophrenia in older adults that can help reduce the risk factors associated with the disorder. 

Additionally, early intervention and medication management can also be effective in preventing the onset of schizophrenia or managing symptoms if the disorder is present. 

It is important to seek professional help if you or someone you know is experiencing symptoms of schizophrenia.

How To Help Someone With Schizophrenia?

These strategies will help you support your loved one on the road to recovery without losing sight of your ambitions and dreams, even though coping with a loved one’s schizophrenia can be difficult.

However, it is crucial to remember that a schizophrenia diagnosis does not constitute a death sentence. Recovery is achievable, especially with your love and support. In order to assist someone with schizophrenia, you should:

  1. Accept the disease and its challenges.
  • Do not believe the lie that someone who has schizophrenia cannot recover or lead a happy, fulfilling life.
  • Make every effort to enhance your loved one’s well-being and quality of life.
  • Consider your own needs as well as your loved one’s.
  • To support your loved one, it is essential to get assistance immediately. Help your loved one find a reputable doctor and begin therapy as soon as possible because early intervention can affect the path of schizophrenia.
  1. Be a team player. Your loved one will be more motivated to pursue recovery if they have a say in their care.
  2. Understand schizophrenia. You can make an educated choice about how to manage symptoms, support your loved one in pursuing self-help techniques, deal with setbacks, and move toward recovery.
  3. Empower your loved one. Be careful not to assume control and perform tasks that they can do independently. Help your loved one while promoting as much self-reliance and independence as possible.
  4. Minimize stress. Stress may make schizophrenia symptoms worse, so it’s crucial to give your loved one an organized, encouraging atmosphere.
  5. Be reasonable in your expectations. It is crucial to be realistic about the difficulties posed by schizophrenia. Be patient with the healing process and assist your loved one in setting and achieving reasonable objectives.

FAQs About Schizophrenia

How does a person with schizophrenia act?

Schizophrenics may have the following negative symptoms:

  • Losing interest and drive in relationships and sex as well as in life in general
  • Changes in sleeping patterns, a lack of focus, and a desire to stay home
  • Being less prone to start conversations, uncomfortable among others, or feeling as though there is nothing to say

Relationship issues with friends and family can frequently result from the negative symptoms of schizophrenia since they can occasionally be misunderstood for willful indifference or rudeness.

Who mostly gets schizophrenia?

The incidence risk ratio for schizophrenia is 1.3–1.4, which is somewhat greater in males than in women. Women tend to experience schizophrenia later in life than men, but there do not seem to be any variations in the prodromal phase’s initial symptoms and indicators between men and women.

How do you prove someone is schizophrenic?

Sadly, the majority of persons with schizophrenia are not aware that their symptoms are red flags for a mental illness. These are the main signs that an older adult has schizophrenia.

  • Delusions: These are erroneous notions that are not supported by reality.
  • Hallucinations: Often, they entail hearing or seeing nonexistent objects.
  • Unorganized thought (speech): Disorganized speech implies chaotic thought.
  • Extreme disarray or unusual motor activity.
  • Negative signs.

What are some examples of schizophrenic thoughts?

Psychosis is a symptom of schizophrenia, and those who experience it may struggle to think rationally, regulate their emotions, and distinguish between what is real and what is not. 

This might involve having extremely bizarre ideas that are abnormal or untrue (delusions), such as the notion that you are being hurt or harassed or that particular gestures or words are intended for you. It can also include hearing or seeing things that are not there (hallucinations).

Wrap Up

For both those who have it and those who care about them, schizophrenia may be a terrifying affliction. Contrary to popular belief, this disease does not preclude the possibility of rehabilitation or of leading a contented, happy life. Speaking with a healthcare physician as soon as possible is crucial if you believe you may be experiencing schizophrenia symptoms.

Healthcare professionals, particularly those with expertise in mental health disorders like schizophrenia, have the training to support you in not feeling judged, humiliated, or embarrassed. Encourage your loved ones to get treatment if you observe that they are exhibiting signs of schizophrenia or psychosis. People can heal and manage this ailment by receiving early diagnosis and treatment.