Elderly people have a higher rate of psychotic symptoms than younger people (Colijn et al., 2015; Devanand, 2011). Among aged people, these symptoms are usually caused by underlying medical conditions such as neurocognitive disorders, the disorders of cognition that you will read about in the next section. Some elderly people, though, suffer from schizophrenia or delusional disorder.

Actually, schizophrenia is less common in older people than in younger ones. In fact, many people with schizophrenia find that their symptoms lessen in later life (Dickerson et al., 2014). Improvement can occur in people who have had schizophrenia for 30 or more years, particularly in such areas as social skills and work capacity, as we are reminded by the remarkable late-life improvement of the Nobel Prize recipient John Nash, the subject of the book and movie A Beautiful Mind. Among those whose schizophrenia does emerge for the first time during old age, women outnumber men by at least 2 to 1 (Ames et al., 2010).

Another kind of psychotic disorder found among the elderly is delusional disorder, in which people develop beliefs that are false but not bizarre (Colijn et al., 2015). This disorder is rare in most age groups—around 2 of every 1,000 persons—but its prevalence appears to increase in the elderly population (APA, 2013). Older people with a delusional disorder may develop deeply held suspicions of persecution; they believe that other people—often family members, doctors, or friends—are conspiring against, cheating, spying on, or maligning them. They may become irritable, angry, or depressed or pursue legal action because of such ideas. It is not clear why this disorder increases among elderly people, but some clinicians suggest that the rise is related to the deficiencies in hearing, social isolation, greater stress, or heightened poverty with which many elderly persons contend.

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