Purohit D P, Davidson M, Perl D P, Powchik P, Haroutunian V H, Bierer L M, McCrystal J, Losonczy M, Davis K L
Department of Pathology, Mount Sinai Medical Center, New York, NY 10029.
Biol Psychiatry. 1993 Feb 15;33(4):255-60. doi: 10.1016/0006-3223(93)90291-k.
The severe cognitive impairment that affects many of the elderly schizophrenic patients could represent the outcome of schizophrenia in old age for the very severe and chronically ill patients or may be the result of lengthy institutionalization and somatic treatment. Alternatively, it could be due to the presence of concurrent dementing disorders, such as Alzheimer's disease (AD) or multi-infarct dementia. Using an identical neuropathological protocol, brain specimens from schizophrenic patients who showed evidence of severe cognitive impairment were compared with 12 age-matched control cases and the same number of age-matched cases of neuropathologically confirmed patients with AD. Despite their relatively advanced age (mean age 77.1 years +/- 2.8), none of the schizophrenia cases showed sufficient degree of senile plaques and neurofibrillary tangle formations to confirm a diagnosis of AD. Other neurodegenerative disorders associated with dementia were also not identified. These studies suggest that alternative explanations need to be sought for the severe cognitive impairment commonly encountered in elderly schizophrenic patients.
影响许多老年精神分裂症患者的严重认知障碍，对于病情极为严重且患有慢性病的患者而言，可能是老年期精神分裂症的结果，或者可能是长期住院治疗和躯体治疗的结果。另外，这也可能是由于同时存在诸如阿尔茨海默病（AD）或多发性梗死性痴呆等痴呆症所致。采用相同的神经病理学方案，将有严重认知障碍证据的精神分裂症患者的脑标本与12例年龄匹配的对照病例以及相同数量的经神经病理学确诊的AD患者的年龄匹配病例进行比较。尽管这些精神分裂症病例年龄相对较大（平均年龄77.1岁±2.8岁），但没有一例显示出足以确诊AD的老年斑和神经原纤维缠结形成程度。也未发现与痴呆相关的其他神经退行性疾病。这些研究表明，需要为老年精神分裂症患者中常见的严重认知障碍寻找其他解释。
