Schizophrenia and Getting Older

As we get older, our bodies age in three ways: physically, cognitively and psychosocially. Our faces wrinkle and health deteriorates; our memories start to fail us and cognitive functions slow down; and we start to feel worse about ourselves and become more withdrawn from society and relationships. These changes are part of our human nature, however with certain preexisting illnesses, such as mental illnesses or physical ailments, aging may be a serious concern.  

For the last 20 years, Dr. Dilip Jeste has studied the effects of aging in 1,500 middle-aged and older people living with schizophrenia and has found some very encouraging results. While it is true that people living with schizophrenia have a higher risk of developing physical illnesses than the general population, they actually do not age any faster cognitively than those living without schizophrenia. Even more promising, his research has shown that psychosocial functioning actually improves with age for people living with schizophrenia. They have learned from the past and are now more able to adhere to mental health treatment, have higher self-esteem and a better quality of life.

To help individuals with schizophrenia age successfully, Dr. Jeste employs the following four types of psychosocial therapy at his clinic in San Diego:

Cognitive behavioral therapy (CBT) and social skills training is a six-month group therapy that has been found to produce a significant improvement in social functioning in the patients who participate.

Functional Adaptation Skills Training (FAST) is a six-month program that provides people living with schizophrenia concrete tips about how to improve things that medication cannot. For example, it teaches participants how to manage their finances, plan events and navigate public transportation. This program showed significant improvement in the social skills of those who participated as well.

Vocational Rehabilitation, and supported employment, helps people with schizophrenia find and maintain jobs. It helps people learn how to communicate with employers and perform their daily tasks. At the end of the training, 70 percent of people who had been found employment were still employed.

Mobile interventions have been very useful in this population as well. Dr. Jeste and his colleagues are able to text their patients reminders about medication, therapy appointments and other important reminders. They have found this to be very successful with their patients.

As Dr. Jeste says, aging successfully with schizophrenia is not a fantasy. It can be a reality provided we give people the right treatment.

Click here [PDF] to read about Dr. Jeste’s call for a new positive psychiatry of aging, and here [PDF] for more information about physical, cognitive and psychosocial aging in schizophrenia.

Dr. Dilip Jeste spoke about aging and schizophrenia on NAMI’s Ask the Doctor call in February. For a schedule of future Ask the Doctor calls and to listen to this call or other past calls, visit www.nami.org/askthedoctor.