Prevalence of negative symptoms and associated factors in older adults with schizophrenia spectrum disorder

Am J Geriatr Psychiatry. 2013 Feb;21(2):100-7. doi: 10.1016/j.jagp.2012.10.009. Epub 2013 Jan 22.


Objective: To examine the prevalence of negative symptoms and associated factors in older adults with schizophrenia spectrum disorder living in the community.

Methods: The sample consisted of a multiracial sample of 198 persons aged 55 and more with a schizophrenia spectrum disorder that developed the disorder before the age of 45; 39% and 61% lived independently and in supported community residences, respectively. George's Social Antecedent Model of Psychopathology was used to examine 16 predictor variables of negative symptoms, based on scores of 4 or more on any of the PANSS negative symptom items.

Results: Forty percent of the sample met the criteria for the presence of negative symptoms, and this decreased to 19% when potential secondary symptoms were excluded. In bivariate analysis, 10 variables were found to be significantly associated with the presence of negative symptoms, but when the model was tested in logistic regression analysis, only 3 variables retained significance: greater positive symptom scores (odds ratio [OR] = 1.26), lower cognitive scores (OR = 0.96), and fewer confidantes (OR = 0.80).

Conclusion: Negative symptoms do not dominate the clinical picture in later life, and levels of negative symptoms appear to be no higher than in younger schizophrenia populations. The relative paucity of significant variables and their modest effect sizes suggest that treatment for negative symptoms in later life will depend largely on strategies directed specifically at the negative symptoms.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Aged
  • Aged, 80 and over
  • Humans
  • Logistic Models
  • Middle Aged
  • Prevalence
  • Principal Component Analysis
  • Psychiatric Status Rating Scales
  • Schizophrenia / diagnosis*
  • Schizophrenic Psychology*
  • Symptom Assessment / methods*