These two conditions share several symptoms in common, and research indicates there may be a direct link.
Schizophrenia and neurocognitive disorder — which used to be called dementia — are serious mental health disorders. Both have symptoms that can disrupt the way you think, form memories, and process the world around you.
The two conditions tend to affect different groups of people. Schizophrenia is most commonly diagnosed in people under age 35, while the average age of diagnosis for a person with neurocognitive disorder is 83.
The causes and treatment options are also very different for each condition.
But despite the many differences between them, schizophrenia and neurocognitive disorder share some symptoms in common, such as:
- hallucinations and delusions
- disorganized speech
- a loss of interest in activities you once enjoyed
- impulsive behavior
And a growing body of research indicates there may be a link between the two conditions.
In recent years, a number of studies have emerged suggesting that schizophrenia may increase a person’s risk of developing neurocognitive disorder.
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But researchers noted that the nature of the association wasn’t clear, and very late-onset schizophrenia is rare, so these findings may not be widely applicable.
Furthermore, it’s not clear whether the person’s emergence of psychosis was an early sign of a neurodegenerative disorder.
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“Dementia” is an older term that was changed to neurocognitive disorder to avoid stigma.
Schizophrenia is a chronic mental health condition that can affect your thoughts, feelings, and behaviors. The condition is characterized by symptoms such as delusions and hallucinations.
Diagnosis
Neurocognitive disorder isn’t a diagnosis in itself. Rather, it’s a general term for a group of progressive mental health conditions with similar or related symptoms. There are many kinds of neurocognitive disorders, but Alzheimer’s disease is the most common type.
Schizophrenia, on the other hand, can be a diagnosis. It’s also a progressive mental health condition with similarities to other diagnoses, such as schizoaffective disorder.
Symptoms
Like schizophrenia, symptoms of neurocognitive disorders can vary but are often characterized by a degenerative loss of memory and some cognitive abilities. Both conditions’ symptoms can become severe enough to interfere with daily life.
Causes
Neurocognitive disorders are typically caused by physical changes in the brain. These changes can sometimes be reversed with the right treatment plan. Other times, they may be permanent.
Schizophrenia is generally not caused by physical changes to the brain, although a
Age of onset
Neurocognitive disorder is most common in older people as they age. In the United States, the average age of onset is 83.
Meanwhile, schizophrenia usually occurs in younger people. The average age of onset for schizophrenia in men is the late teens to early 20s. For women, age of onset is the late 20s to early 30s.
However, early onset of neurocognitive disorders can happen. They appear to be on the rise, according to a 2020 report.
The symptoms of these two conditions may have some overlap, but there are also key differences.
Symptoms of neurocognitive disorder
Symptoms of neurocognitive disorder typically vary depending on the underlying cause. They almost always involve a significant loss of cognitive functioning, or the ability to think.
Symptoms can include:
- Memory loss: forgetting routine things like names or directions, getting lost in familiar surroundings, repeating questions or conversations
- Speech challenges: difficulties with speaking or expressing thoughts, frequently forgetting simple words, or substituting an unusual word for a familiar one
- Physical difficulties: experiencing problems with coordination or balance
- Impulse control: an onset of challenges with impulsive behavior
- Psychosis: experiencing hallucinations, paranoia, or delusional beliefs
Symptoms of schizophrenia
According to the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5), schizophrenia can involve the following symptoms:
- Hallucinations: hearing, seeing, or otherwise perceiving things that aren’t really there
- Delusions: a strongly held belief in something, despite evidence that the belief is false, such as believing that you are being followed, are controlled by external forces, or that your loved ones are imposters
- Disorganized speech: incoherent or unconnected speech that can be difficult for others to follow
- Disorganized behavior: can involve catatonia or unusual body movements
- Negative symptoms: the absence of a trait that would usually be present, such as affect, speech, or social engagement
A person must experience two or more of these symptoms, including at least one of the first three symptoms, for at least 1 month to receive a diagnosis of schizophrenia.
Many factors may play a role in causing both schizophrenia and neurocognitive disorders.
Causes of neurocognitive disorder
A number of underlying conditions can cause neurocognitive disorder, such as:
- Alzheimer’s disease. This degenerative brain condition gradually affects a person’s memory, ability to think, and ability to function independently.
- Vascular dementia. A restriction in blood flow to certain regions of the brain causes a decline in thinking ability.
- Dementia with Lewy bodies. Abnormal protein deposits in nerve cells can cause neurocognitive disorder.
- Parkinson’s disease. It’s common for people living with this condition to develop neurocognitive disorder.
- Creutzfeldt-Jakob disease. Sometimes called “mad cow disease,” this very rare degenerative condition causes unique changes in brain tissue, which can cause neurocognitive disorder.
- Wernicke-Korsakoff syndrome. A brain disorder caused by severe vitamin B deficiency resulting from alcohol misuse.
The two most common causes of neurocognitive disorder are Alzheimer’s disease and vascular dementia.
Causes of schizophrenia
A number of factors may contribute to the potential causes of schizophrenia, including:
- Genetics. People who have family members with schizophrenia may have a higher risk of developing the condition themselves. The
risk rises to around 6.5% in those who have a close relative, versus 1% in the general population. - Brain activity. Neurotransmitters, which are the body’s chemical messengers, seem to function differently in people with schizophrenia. Changes in dopamine and serotonin levels may be a cause.
- Substance use. Certain substances may trigger schizophrenia to develop in some people. A link has been identified between cannabis and schizophrenia, although
2020 research suggests that the causal effect is likely to be small. - Environmental factors. According to a 2021 review, certain infections and early life experiences may be associated with schizophrenia, as well as being raised in an urban environment.
Schizophrenia is typically caused by two or more of these factors. For instance, a person may have a genetic predisposition to schizophrenia but never develop the condition unless they also experience an environmental trigger, such as stress or substance use.
There’s no single, conclusive diagnostic tool for either condition.
If a doctor suspects a person has neurocognitive disorder, they may run a number of tests to help pinpoint the cause.
Diagnosis may involve cognitive and psychological tests to determine how well the brain is functioning. A doctor may also order scans and laboratory tests to look for physical changes in the brain that may indicate Alzheimer’s disease or another form of neurocognitive disorder.
Doctors cannot diagnose schizophrenia from brain scans or other tests. The condition is typically diagnosed after one or more episodes of psychosis, and after other conditions have been ruled out as the cause.
Per the DSM-5 criteria, at least two symptoms must be present for at least 1 month.
Neither neurocognitive disorder nor schizophrenia have a cure, but researchers are working hard to find effective preventive measures for conditions like Alzheimer’s.
At the moment, treatment for both conditions often consists of a combination of:
- medication
- therapy
- social support
- cognitive or occupational training
- self-care and lifestyle changes
It’s important to work with a doctor on finding the best treatment plan for you, which may take time as well as trial and error.
The right treatment plan can help you:
- manage symptoms
- support everyday functions and independence
- maximize quality of life
- slow the progression of cognitive decline in neurocognitive disorders
Medication
Medication can help mitigate the symptoms of schizophrenia and neurocognitive disorder. Doctors commonly prescribe antipsychotics for both conditions.
For neurocognitive disorders, antipsychotics may help relieve:
- mood instability
- psychosis
- agitation
- aggression
Antipsychotic drugs can also be highly effective for treating schizophrenia symptoms, such as reducing or eliminating delusions and hallucinations.
Other types of medications that may help treat symptoms of neurocognitive disorder include:
- cholinesterase inhibitors
- memantine
- selective serotonin reuptake inhibitors (SSRIs)
Therapy
Psychotherapy can help both neurocognitive disorder and schizophrenia, especially with:
- working through difficult emotions related to your diagnosis or quality of life
- connecting you with support groups
- finding resources outside of therapy
Types of therapy that may be helpful include:
- Cognitive behavioral therapy (CBT). CBT focuses on creating a healthy separation between a person and their thoughts. It may be helpful for people who experience psychosis.
- Validation therapy. In this therapy, caregivers and therapists create a warm, trusting atmosphere by using communication techniques to help make people with memory loss from neurocognitive disorder feel understood, safe, and accepted without judgment.
- Reminiscence therapy. With reminiscence therapy, a therapist encourages you to talk about things you remember, such as your hometown, where you work, or your school, either individually or in a group setting. This may help with mood and cognitive performance.
- Occupational therapy. Practicing everyday activities can help with maintaining functionality and independence in life.
Social support
Social connections and support can be immensely helpful for people living with these conditions.
If you or a loved one has either schizophrenia or neurocognitive disorder, consider forming a network of friends, family, and neighbors you trust to listen empathetically and help when needed.
Loved ones who are involved in caregiver education and training programs can also help people with neurocognitive disorder keep their independence and functional abilities sharp.
You can also ask your doctor or therapist to help connect you to support groups where you can meet others with similar life experiences.
Lifestyle and self-care
Some experts believe nonpharmacological methods should be first-line treatments for neurocognitive disorders because of the risks and side effects associated with antipsychotics.
Some options that do not involve medications include:
- eating nutritious foods
- cognitive interventions, such as word or number puzzles
- regular exercise
- reflexology
- aromatherapy
- music and art therapy
- memory and coordination exercises
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Lifestyle and self-care can also be integral for people with schizophrenia. Many of the above options can help this condition as well.
Some additional lifestyle and self-care interventions for people with schizophrenia include:
- reducing stress
- creating a plan for managing difficult times, such as episodes of psychosis
- setting small goals for your life
- continuing to do what you enjoy
Getting a diagnosis of either schizophrenia or neurocognitive disorder can be an alarming and overwhelming experience.
But you are not alone, and learning as much as you can about your condition can help you feel more empowered as you navigate your or a loved one’s diagnosis.
While neurocognitive disorder and schizophrenia have key differences that set them apart, they also have some similarities. Namely, they both have treatment options that can help manage symptoms and improve quality of life and everyday independence.
Treatment plans often include a combination of:
- medication
- therapy
- lifestyle changes and self-care
Talking with your doctor about your symptoms is a good place to start when seeking treatment. It may take time and effort, but finding relief is possible.