Aging with Schizophrenia: What You Need to Know

Schizophrenia and aging

Research suggests that the severity of your symptoms may have more to do with the age you were when your symptoms first started than the age you are now.

Still, people with schizophrenia tend to age faster than the general population. This is likely due to a combination of factors and not just the disorder itself.

According to a 2018 research review, studies have found that people with schizophrenia have higher levels of oxidative stress than people without the condition. Oxidative stress is aging that takes place at the cellular level. During this process, your body slowly loses its ability to repair cell damage.

Oxidative stress is linked to schizophrenia but isn’t necessarily the result of the condition itself. It’s probably linked to schizophrenia-related factors like:

• lower income and economic stress
• inflammation
• medication side effects
• smoking

Symptoms in later life

Symptoms of schizophrenia are usually divided into three groups:

• Positive symptoms. These are symptoms that most people without schizophrenia don’t experience. They are usually symptoms associated with psychosis, such as hallucinations and delusions.
• Negative symptoms. These are things present in most people but absent in people with schizophrenia. Examples include an inability to feel joy (anhedonia) and a lack of motivation (avolition).
• Cognitive symptoms. These symptoms are related to learning, memory, concentration, and decision making.

It’s unclear how positive and negative symptoms progress with age. When looking at people with schizophrenia during later stages of life, a 2016 study produced conflicting results about these symptoms.

People with schizophrenia also tend to have a lowered ability to think during older age than people without, according to 2015 research. It’s unclear whether the rate of decline is similar to that of the general population or if schizophrenia causes a quicker decline.

Lower cognition may mainly result from a significant decline that happens when schizophrenia first starts.

Research from 2013 suggests that living in a care facility may increase your risk of cognitive decline. Since the staff manages many day-to-day activities, residents have fewer mental demands. Not exercising the brain increases the risk of greater cognitive decline.

Is remission possible?

Remission is a period of 6 months or longer when your symptoms are less severe. The symptoms healthcare professionals are likely to consider are:

• disorganized thinking
• delusions
• hallucinations
• blunted affect or little emotion
• social withdrawal
• inability to be spontaneous
• repetitive movements or mannerisms
• unusual thoughts

Remission is possible for many people. In fact, a 2021 study of 129 participants found that 16 to 78 percent of people with schizophrenia have periods of remission. Similarly, a 2019 study of 77 older people with schizophrenia found that roughly half of the participants achieved remission.

What makes the difference for many people? Social support. Having a partner, family, or community to help you manage symptoms has a big impact on the likelihood of remission. For that reason, it’s important to strengthen support networks around people with schizophrenia.

Physical health complications of aging with schizophrenia

People with schizophrenia have a lower life expectancy than the general population. The National Institute of Mental Health estimates that schizophrenia could shorten your life by as much as 28.5 years.

That number is influenced by many different health factors, some of which you may be able to control, such as smoking.

People with schizophrenia have a higher risk of developing certain health conditions as they get older. This is partly because healthcare professionals may overlook signs of physical illness in people with a mental health condition. It can also be easy to neglect your physical health if you’re dealing with other effects schizophrenia has on your life.

Here’s what we know about the health risks linked to schizophrenia:

Congestive heart failure

Schizophrenia affects your heart. It can change your heart rate and raise your risk of congestive heart failure, according to a 2022 study.

When you have congestive heart failure, your heart loses its ability to pump blood as well as it should. That means your organs don’t get the oxygen-rich blood they need to work properly.

Often, when someone with schizophrenia dies at an earlier age than expected, it’s because of cardiovascular disease (CVD).

Chronic obstructive pulmonary disease

Chronic obstructive pulmonary disease (COPD) is more common among people with schizophrenia than in the general population, according to 2019 research. Some researchers think this could be because people with schizophrenia tend to smoke more often and for longer periods than the general population.

When you have COPD, your airways become blocked. This makes it more difficult to take deep breaths.

Diabetes

The risk of developing diabetes is two to five times higher if you have schizophrenia, though the relationship between these two conditions is complex.

Medication side effects and the amount of physical activity you get both play a role. Some people with schizophrenia still develop diabetes even if they’ve never taken antipsychotic medications, though it’s unclear why.

Dementia

People with schizophrenia may have a higher risk of developing dementia later in life, according to 2018 research. It’s not completely clear why this is the case.

It may be that other health conditions, like diabetes and CVD, make dementia more likely. It could also be influenced by medication side effects, the use of alcohol or tobacco, or low physical activity.

Some researchers think that schizophrenia affects your memory and thinking abilities more as you age.

Parkinson’s Disease

Parkinson’s disease is a health condition that affects your nervous system. This condition disrupts your ability to walk, balance, and move. People with schizophrenia have a greater risk of developing Parkinson’s disease as they get older, according to 2021 research.

Medication side effects may be part of the reason. It’s also likely that schizophrenia affects the amount of dopamine your body produces. Dopamine is a key brain chemical that aids movement.

Cancer

There’s a 50 percent higher risk of certain cancers in people with schizophrenia. Studies have found a higher risk of developing breast, lung, pancreatic, esophageal, and colon cancers.

It’s important for people with schizophrenia to have regular cancer screenings. Early detection is often key to a successful treatment.

Mental health complications of aging with schizophrenia

Older adults with schizophrenia sometimes experience additional mental health conditions at the same time. For example, anxiety and depression can sometimes increase with age.

People with schizophrenia have a higher risk of suicidal thoughts and actions. A 2019 review suggests that this risk is higher in younger people who have been recently diagnosed.

Some medications that have been shown to lower the risk of suicide include:

• clozapine
• risperidone
• olanzapine
• quetiapine

Antidepressants can also help. A mental health professional will help best determine a treatment plan if medication is needed.

Other interventions may help manage suicidal thoughts or symptoms of depression and anxiety. These include:

• social support networks
• teaching positive coping skills
• behavioral therapy

Treating schizophrenia as you age

The best way to improve your mental and physical health as you get older is to stick with your treatment plan. It’s also important to keep up with annual screenings so you can detect any other potential health conditions that need to be treated.

Antipsychotics

As you get older, you may not need as high a dose of antipsychotic medication. In fact, antipsychotic medications can cause different side effects in older adults. They may even lead to a decline in your reasoning abilities.

If you’re noticing new symptoms or side effects, it’s a good idea to speak with a healthcare professional. They may recommend a lower dose or a different medication.

Psychosocial interventions

The quality of your life as an older adult with schizophrenia can be markedly improved with psychological and social treatment methods. In fact, 2014 research suggests you may enjoy more positive social interactions as you get older.

These interventions may help you stay connected and feel supported:

• cognitive behavioral therapy
• functional adaption skills training
• community living training
• supported job skills training
• cognitive behavioral social skills training
• financial management training
• self-management and self-care strategies
• group, individual, and family therapy

You may want to consider living in a health home to make accessing these types of treatment programs easier. Health homes are a program of Medicaid offering support for people with chronic illnesses.

Lifestyle changes

To lower your risk of disease and improve your mental and physical health, it’s important to maintain a balanced diet, avoid tobacco products, and get plenty of exercise — outdoors, if possible.

These guidelines are important for everyone but can have a powerful impact on the lives of older adults with schizophrenia.

Outlook

Schizophrenia presents some serious challenges to the health and well-being of older adults. In some cases, it increases the risk of an earlier death. You may develop health conditions that affect your heart, metabolic system, lungs, or mobility. You may also have to cope with depression or anxiety.

Even so, there are steps you can take to manage your risks and improve your quality of life. Building a strong connection with your family, friends, and community is one. Having annual health screenings is another.

You can also look after your health day to day by eating well, staying active, and avoiding tobacco products. Perhaps the most important thing you can do to improve your outlook is to keep up with your schizophrenia medications and the rest of your treatment plan.