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S012-1

Cognition and Psychosocial Function of Old Schizophrenia in the Community:
12-Year Outcome of “Sasagawa Project” in Japan

Hidehito Niimura

Keio University & Asaka Hospital, Japan

Background/Objective: Age-associated decline in physical and cognitive functions stands in
contrast to an enhancement of subjective quality of life and psychosocial functioning in people with
schizophrenia. Seventy eight middle-aged and elderly patients with schizophrenia who had been
hospitalized for decades were transferred to the community after the closure of the hospital in the
“Sasagawa Project” since 2002. We report the 12-year follow-up outcome regarding the physical,
cognitive and psychosocial function.

Method: A total of 51 male and 27 female chronic patients with schizophrenia who discharged from
the hospital and started community dwelling in 2002 were recruited. The mean age of illness onset
was 23.4 (SD 5.8) years; mean age at the index discharge was 53.9 (SD 6.8) years. The mean
duration of the index hospitalization was 24.6 (SD 9.9) years. We assessed the re-hospitalization days
after the index discharge, psychiatric symptoms (PANSS), global functioning (GAF), social
functioning (SFS), quality of life (WHOQOL26), global cognition (MMSE) and laboratory data at
baseline, 1, 2, 3, 4, 5 and 12 years later the discharge and analyzed statistically.

Result: In January 2015, 12 years after the index discharge, 42 male and 19 female patients (78.2%)
survived in the community. Improvement in overall functions, including cognition and psychiatric
symptoms, were observed within five years after discharge. Twelve years later all patients reached
the geriatric age and preserved the social functioning and quality of life, but their physical functions,
psychiatric symptoms, global cognition and global functioning declined.

Conclusion: Though subjectively psychosocial functioning appeared to be maintained, cognition and
physical functioning objectively deteriorated. In spite of integrated community care, it remains
difficult for patients to maintain life in the community and prevent re-admission. We should refine
the way to support older individuals with schizophrenia in the community.