Late-onset paranoid disorder.

While the onset of paranoid states in the geriatric population has received some attention, recent research results on such proposed etiological factors as sensory impairments, cognitive decline, and pre-existing schizophrenia-spectrum pathologies remain equivocal. The authors present an alternative hypothesis positioning the interaction of pre-existing narcissistic personality features with unique aspects of the aging process. Case studies and innovative treatment strategies are discussed.