Clinical and cognitive diversity of XXXX states arising in late life (late paraphrenia).

@entity1 @entity73 @entity716
This study aimed to explore the heterogeneity of @entity716 with onset in late life by using cognitive factors in a centroid method of cluster analysis. Forty-seven subjects were allocated to two different clusters, the first with 24 (51.1%) and the second with 23 (48.9%) @entity1 . Their cognitive attainment was evaluated against the performance of 33 elderly controls, all groups being matched for age, sex, and the numbers of years of education. @entity1 in cluster 2 showed a pattern of widespread @entity73 , which involved general measures of cognitive performance (MMSE, CAMCOG, WAIS-R verbal and performance scores), memory (digit and spatial span, delayed matching-to-sample, recognition memory for words and faces), and executive functions (verbal fluency, extra and intra-dimensional shift ability, spatial working memory, and planning). In contrast, @entity1 in cluster 1 were only impaired on their extra-dimensional set shift and planning abilities, suggesting a more specific and restricted executive functioning deficit. We also analysed the impact that the use of antipsychotic medication could have had on @entity1 ' cognitive performance, which was shown to be negligible. In addition, there was no difference between the clusters with regard to the number of @entity1 using neuroleptics, suggesting that the medication was unlikely to have introduced a performance bias in the two @entity1 clusters. The validity of the subdivision of these @entity1 into two separate groups was further supported by other clinical findings. @entity1 in cluster 1 exhibited more severe @entity716 , as measured by the SAPS, than their counterparts in cluster 2, and were also more likely to display first-rank symptoms of Schneider. Conversely, cluster 2 membership was strongly associated with the presence of neurological signs and negative symptoms. We suggest that @entity716 states arising in late life are a heterogeneous condition that may be best divided in two: 'type A', including @entity1 with a wide range of @entity716 , mild increase in the frequency of neurological signs, and @entity73 restricted to executive functions, and 'type B', which includes @entity1 with less complex @entity716 associated with a marked increase in the frequency of neurological signs and generalized @entity73 . The basis for this subdivision and the prospect for future studies are discussed.
