Thought, language, and communication deficits and association with everyday functional outcomes among community-dwelling middle-aged and older adults with schizophrenia.

Schizophr Res

Department of Psychiatry, Leonard M. Miller School of Medicine, 1600 NW 10(th) Avenue, Miami, FL 33136, USA; Research Service, Bruce W. Carter VA Medical Center, 1201 NW 16(th) Street, Miami, FL 33125, USA.

Published: June 2018

Older adults with schizophrenia experience poorer community integration and social functioning compared to same-age peers with no mental health disorders; these individuals are at elevated risk for functional decline and early institutionalization in long-term care facilities. Deficits in thought, language, and communication (TLC; that is, thought disorder and alogia) are core features of schizophrenia and may worsen with age; however, little research focuses on the functional sequelae of these impairments among older adults with schizophrenia. The present study aimed to examine the relationships among age, TLC deficits, and functional outcomes in a sample of community-dwelling middle-aged and older adults with schizophrenia (N = 245; ages 40-85). Participants completed assessments of symptoms, neurocognition, TLC deficits, and functional outcomes. Two different categories of TLC deficits were examined: verbal underproductivity (i.e., alogia) and disconnected speech. Regression analyses, controlling for gender, age, Veteran status, smoking status, cognitive impairment, and symptom severity, found that disconnected speech predicted occupational functioning, while verbal underproductivity predicted capacity to communicate skillfully in semi-structured social situations, as well as community functioning across interpersonal, occupational, and everyday living domains. Exploratory mediation analyses found significant indirect effects of age, through TLC deficits, on certain functional outcomes. Targeted training to improve TLC deficits, especially verbal underproductivity, among older adults with schizophrenia could have downstream effects on community functioning, improving outcomes for a vulnerable group.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5794645PMC
http://dx.doi.org/10.1016/j.schres.2017.07.017DOI Listing

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