Biaggi Nicolas, Potts Jacklyn, Torres Alfred, Verzura Melissa L, Bourne Ashley S, Cruz Jose
Psychiatry, Mount Sinai Medical Center, Miami Beach, USA.
Dr. Kiran C. Patel College of Osteopathic Medicine, Nova Southeastern University, Fort Lauderdale, USA.
Cureus. 2025 Mar 12;17(3):e80482. doi: 10.7759/cureus.80482. eCollection 2025 Mar.
The emergence of psychiatric symptoms in late life presents a diagnostic challenge due to their overlap with neurodegenerative disorders. This case details a 66-year-old male with acute psychosis, initially raising concerns for an underlying neurodegenerative-related process. Comprehensive evaluation, including neuroimaging and laboratory studies, excluded neurodegeneration, leading to a diagnosis of very late-onset schizophrenia. The patient demonstrated clinical improvement with an atypical antipsychotic, while an acetylcholinesterase inhibitor was discontinued due to the absence of neurodegenerative pathology. This case highlights the critical role of thorough diagnostic assessment in differentiating primary psychiatric disorders from neurodegenerative conditions in older adults.
由于精神症状在老年期的出现与神经退行性疾病存在重叠，故而带来了诊断方面的挑战。本病例详细介绍了一名66岁患有急性精神病的男性，最初引发了对潜在神经退行性相关疾病的担忧。包括神经影像学和实验室检查在内的全面评估排除了神经退行性病变，最终诊断为极晚发性精神分裂症。该患者使用非典型抗精神病药物后临床症状有所改善，而由于不存在神经退行性病理改变，停用了乙酰胆碱酯酶抑制剂。本病例强调了全面诊断评估在区分老年人原发性精神疾病和神经退行性疾病方面的关键作用。
