Psychotic symptoms in the elderly: A prospective study in a population sample

Background. Most of what is known about psychotic symptoms in older persons is based on hospital series of severe disorders. Method. In the course of a longitudinal community-based survey of older persons, the presence of psychotic symptoms was assessed on two occasions 3-4 years apart. Results. The point prevalence was 5.7%. Risk factors were cognitive impairment, living alone, being male, having had limited education, social isolation, poor health and depressive symptoms. Of the 65 persons who were symptomatic at the start, only six of those still alive had one or more psychotic symptoms after 3-4 years. The incidence was 6.0% over a period of 3.6 years. Conclusions. Risk factors for psychotic symptoms in later life lie in age-related cognitive impairment in interaction with a range of environmental and psychosocial variables.