Cognitive profiles in older adults with psychotic disorders: Results from routine clinical assessments

Objectives: Cognitive impairment is common in older adults with psychotic disorders; however, few studies have examined their performance on widely used cognitive screening tools. This study aimed to characterize the cognitive profile of this population using four commonly administered instruments: the Mini-Mental State Examination (MMSE), the Modified Mini-Mental State (3MS), the Montreal Cognitive Assessment (MoCA), and the Frontal Assessment Battery (FAB). Methods: In this descriptive cross-sectional study, 77 adults aged ≥60 years with a diagnosed psychotic disorder underwent cognitive assessment using the MMSE, 3MS, MoCA, and FAB. Demographic and clinical data were also collected, including psychiatric symptom severity (Positive and Negative Syndrome Scale; PANSS), functional status (Specific Level of Functioning Scale; SLOF), and education level. Results: Median scores were 28/30 (MMSE), 92/100 (3MS), 22/30 (MoCA), and 15/18 (FAB). Cognitive deficits were most prominent in delayed recall, verbal fluency, inhibitory control, abstraction, and visuospatial function. Principal component analysis revealed strong positive correlations among cognitive performance, educational attainment, and functional capacity. PANSS total and negative symptom scores were negatively correlated with MMSE, 3MS, and FAB scores. No distinct cognitive subgroups were identified, suggesting a relatively homogeneous cognitive profile across the sample. Conclusions: Older adults with psychotic disorders exhibit consistent impairments across specific cognitive domains. Familiarity with these patterns may help clinicians distinguish typical cognitive changes in this population from atypical profiles that warrant further investigation, including referral to geriatric psychiatry or memory clinics.