How to manage schizophrenia symptoms at 62?

Question

Hi doctor,

My dad is a 62-year-old male and has lived with schizophrenia for decades. The hallucinations are mostly controlled now, but lately, the isolation, low motivation, and memory issues seem harder on him than the psychosis itself. He spends most of the day alone and has trouble sticking to routines unless someone reminds him. We are trying to help without making him feel like he is losing independence.

For people dealing with schizophrenia later in life, what actually helps maintain quality of life and daily functioning?
Does aging make symptoms harder to manage even if someone’s been stable for years?

Please help.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com

I have read your query and can understand your problem.

Your given history is suggestive of negative symptoms and cognitive impairment. As people age, positive symptoms usually decrease, while negative symptoms and cognitive impairment steadily increase. A cause of cognitive impairment is schizophrenia itself, and antipsychotic drugs also contribute to it.

These are common in older persons with schizophrenia and can have a major impact on daily functioning and the capacity to carry out daily tasks on one's own. However, many people can maintain a high standard of living with the right medical care and family support. It is necessary to see a psychiatrist regularly to check the symptoms, evaluate drug reactions, and modify treatment as needed.

Cariprazine, Aripiprazole, Lurasidone, Ziprasidone, and Lumateparone are examples of more recent antipsychotics that are useful in treating negative and cognitive symptoms. Antidepressants must be used to treat underlying anxiety and depression symptoms when they are present.

Exercise, yoga, social skills training, and organized daily activities are examples of behavioral modifications that can be beneficial. Maintaining a regular schedule, engaging in cognitive activities like reading, puzzles, or memory exercises, and encouraging participation in basic daily tasks can all assist in sustaining mental function and boosting confidence.

Also consider reducing the dose of antipsychotics and any anticholinergic drug. If appropriate, such changes should be done under the supervision of your treating psychiatrist. Medication changes should never be made without medical advice.

I am hoping that the above information was helpful for you.

If you have any other questions, feel free to contact me.

Thank you.