Does Schizophrenia Get Worse with Age?

The Typical Course of Schizophrenia

Schizophrenia is a complex, chronic mental health condition that’s experienced by an estimated 24 million people around the world, according to the World Health Organization (WHO). 

Understanding the typical course of schizophrenia is crucial for both behavioral health researchers and those impacted by the condition.

Although schizophrenia can occur at any age, most diagnoses are made in late teens to early adulthood. Men tend to exhibit symptoms earlier than women. They also seem to have worse premorbid functioning — that is, poorer psychosocial functioning before the onset of symptoms. 

While research once suggested that schizophrenia is likely more prevalent in men than women, the numbers may be closer than previously thought, although more men are diagnosed than women. 

There are 3 distinctly identifiable phases that can characterize the course of schizophrenia:

1. Prodromal phase: The prodromal phase of schizophrenia comes before the onset of full psychotic symptoms. It’s generally marked by subtle changes experienced in behavior, mood, and cognitive function. People might begin to withdraw socially or experience a lack of motivation during this phase. These signs may be coupled with unusual beliefs and difficulty concentrating.
2. Active phase: During the active phase, periods of psychotic symptoms will be quite evident. Common symptoms of schizophrenia include hallucinations (seeing or hearing things that aren’t actually present), delusions (having false beliefs), disorganized thinking and speech, and obvious disorganized behavior. The severity and frequency of schizophrenia symptoms during the active phase can widely vary from person to person.
3. Residual phase: After the active phase, some people experience a residual schizophrenia phase. This phase is characterized by partial remission of symptoms. Although some symptoms may still be present during this time, they’re generally less severe than in the active phase.

Early-onset vs late-onset schizophrenia

Because schizophrenia can manifest at different points in someone’s life, it’s important to distinguish between early-onset and late-onset stages.

• Early-onset schizophrenia refers to when symptoms develop before someone is 18 years old. It often includes more severe symptoms and typically has a less positive prognosis compared to late-onset. People with early onset schizophrenia often experience social and cognitive developmental delays and have difficulty in school and occupational functioning.
• Late-onset schizophrenia describes when symptoms begin after the age of 40. It usually develops slowly and gradually over time, making a schizophrenia diagnosis more difficult in some cases. Although late-onset schizophrenia is less common, it still creates unique challenges for older patients because of factors like age-related comorbid medical conditions as well as brain structure and function change (also due to age).

What Research Says About Schizophrenia & Aging

Schizophrenia is generally considered a lifelong condition, although some recent research suggests that recovery or significant improvement in symptoms is possible, especially with appropriate interventions in place. 

Additional research conducted explicitly on schizophrenia aging offers insight into the impact of aging on quality of life, symptom severity, and physical health. It makes sense that with age comes other complications and medical comorbidities. 

Other recent findings discovered that the brains of some people with schizophrenia, as well as older adults, have similar gene activity, suggesting there may be a shared biological basis that contributes to cognitive impairment in both populations. 

Impact of Age on Treatment Responses

Age can significantly impact how people with schizophrenia respond to treatment. Here are some key considerations:

• Increased vulnerability: Older adults may be more vulnerable to certain side effects of medications used to treat schizophrenia.
• Cognitive decline: Age-related cognitive decline can affect treatment adherence and therapeutic outcomes.

Due to these concerns, it is crucial that interventions for treating schizophrenia take into account age-related factors. This approach helps to maximize efficacy while minimizing the potential for adverse effects.

What Causes Schizophrenia to Get Worse?

Several factors can exacerbate schizophrenia symptoms. Non-adherence to medication, substance abuse, stressors stemming from life changes or trauma, and social isolation are all known contributors that can potentially worsen symptoms.

Genetic or biological factors

Genetic predispositions and biological factors are believed to potentially worsen schizophrenia symptoms. It’s thought that gene variations related to neurotransmitter function and brain structure can contribute to increased symptoms.

Environmental influence

Environmental factors and exposure can play a role in schizophrenia, according to studies. Findings suggest that stressful life events, trauma, upbringing, and lack of support all might cause symptoms of schizophrenia to worsen over time.

Comorbidity with other health issues

Comorbid conditions — conditions that occur in addition to schizophrenia — including substance use disorder, mood disorders, and other physical health conditions can increase the prevalence and severity of symptoms. Managing co-occurring conditions is vital to positive treatment outcomes and improved overall well-being.

Poor medication or treatment compliance

Poor medication or treatment compliance can result in worsening schizophrenia symptoms. It can also lead to increased frequency and severity of psychotic episodes. Not adhering to antipsychotic medication regimens can substantially decrease the effectiveness of therapy for schizophrenia and other interventions.

Lifestyle and habits

Maintaining an unhealthy lifestyle habit — like poor diet, minimal or no exercise, or unhealthy sleep patterns — can substantially exacerbate symptoms of schizophrenia. Additionally, substance use or abuse and lack of self-care routines might also make symptoms worse.

Challenges in Older Adults with Schizophrenia

As people with schizophrenia age, they face several challenges that can complicate their condition and overall quality of life:

• Physical health declines: Aging can exacerbate physical health issues, worsening existing symptoms of schizophrenia and increasing the likelihood of developing other medical conditions.
• Increased caregiver support: There is often an increased need for caregiver support due to continued cognitive and functional decline in older adults with schizophrenia.
• Social isolation: Increased social isolation can lead to intensified loneliness and an uptick in psychiatric symptoms, further impacting mental health.
• Complicated treatment: Symptoms of schizophrenia can interact with age-related conditions like dementia, making treatment more complex. Research suggests that people with schizophrenia have a significantly higher risk of developing dementia.

Getting Help Early On

Early and consistent intervention is vital for optimal schizophrenia treatment outcomes, even if you feel that you have high-functioning schizophrenia. Schizophrenia aging complications can vary from person to person, but having an effective treatment plan in place offers the best hope for managing symptoms and improving quality of life. Talkspace makes getting treatment for schizophrenia easy with online therapy for schizophrenia and prescribed medications if needed. 

Access to mental health professionals is both convenient and affordable with Talkspace. If you or someone you love is worried about how to manage schizophrenia with age, reach out to Talkspace for support. Start online treatment for schizophrenia today.