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Functional Impairment in Older Schizophrenic Persons

Toward a Conceptual Model

Received May 24, 1999; revised August 12, 1999; accepted October 22, 1999. From the Department of Geriatric Psychiatry, SUNY Health Science Center at Brooklyn, Brooklyn, New York. Address correspondence to Dr. Cohen, SUNY Health Science Center at Brooklyn, Box 1203, 450 Clarkson Ave., Brooklyn, NY 11203.

The authors examined the determinants and consequences of impaired functioning in older schizophrenic persons by adapting a model of impairment developed by Berkman and Gurland. The sample consisted of 117 persons age 55 or older with a DSM-III-R diagnosis of schizophrenia. In logistic-regression analysis, the overall model attained significance in predicting functional impairment, and three predictor variables—abnormal movements, use of antiparkinsonian agents, and negative symptoms—attained independent significance. Functional impairment had a direct effect on two of the seven resultant variables, community activities and self-health, and an indirect effect on two other resultant variables, depression and life satisfaction. Thus, the Berkman–Gurland Model has potential usefulness for exploring functioning impairment among older schizophrenic persons. Moreover, the variables that have the greatest impact on functional impairment are potentially remediable.

Key Words: Schizophrenia Spectrum Disorder • Measures of Functioning • Social/Demographic Factors

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