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Release: Oct. 3, 2001

UI researchers studying aging and psychosis

IOWA CITY, Iowa -- Engaging socially with others, particularly through a good marriage, has been associated with the extent to which elderly people keep their minds mentally fit. A recent University of Iowa investigation supports this connection, based on a study of elders living in noninstitutional residences in their communities.

Previous studies have looked at the association between psychotic symptoms and aging for people who live in nursing home and patient care settings. However, the UI study was unusual in its focus on elders aged 70 and older who still live in their own home or a relative's home, said Carolyn Turvey, Ph.D., UI assistant professor of psychiatry and primary author of the study.

"Some elders who have cognitive impairment also have psychotic symptoms. They hear or see things that aren't really there or they hold unrealistic beliefs," Turvey said. "However, these symptoms present themselves differently than they do in younger people who have conditions such as schizophrenia or manic depression. This suggests that the presence of psychotic symptoms is a different disorder in the elderly, and it doesn't have the same correlates, or associations."

The study was based on 822 proxy interview for elders aged 70 and older who lived throughout the United States, including Iowa, and had participated in a larger study on aging conducted by the University of Michigan Institute for Social Research. Proxy interviewing involves asking people questions about another person's health. The elders were unable to complete their own interviews because of cognitive or physical disabilities.

In the study, spouses (36 percent) or other people close to the elders (64 percent) were asked whether the elders had hallucinations or paranoid delusions. In addition, depression symptoms and cognitive levels were assessed for each elder.

"People who experience psychotic symptoms late in life tend to have sensory impairment such as trouble with hearing and vision, memory problems and depressive symptoms. They also tend to live alone," Turvey said.

For example, an individual with a sensory limitation such as macular degeneration, a form of blindness, may report having more psychotic symptoms. The symptoms may be part of a compensatory process that is related to the loss of sensory function.

"One theory is that the brain generates hallucinations to compensate, or make up, for the loss," Turvey said. "In other cases, people's minds may generate delusions as a way of explaining confusing sensory experiences or lapses in memory."

In addition, social isolation has an association with psychotic symptoms. Turvey noted that an association is not the same thing as a cause but can provide the basis for further research to determine the causal relationship. In fact, an association, or correlation, indicates that the causal relationship between the two things is not clear, similar to the chicken-and-egg problem.

Turvey will continue to study the relationship between social isolation, depression and functional decline. She has a particular research interest in how marital status and quality of marriages influence how elders cope with the challenges of aging.

"My goal is to learn how people can age more successfully," she said. "Although people focus on raising children or making a nice home as the main work of marriage, the degree to which spouses rely on one another and the role they can have in helping each other age well is very important.

"A supportive marriage or a similar close relationship can promote health, keep a person mentally alert and promote more independent functioning," Turvey added.

The findings were published in the June issue of International Psychogeriatrics.

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