Classical "late onset schizophrenia", i.e. schizophrenia with onset after age 40, was analysed on the basis of different representative populations. Its incidence in women was about twice as high as that in men in this age group. Late onset schizophrenia did not markedly differ from early onset schizophrenia in terms of symptomatology, especially regarding nuclear psychotic symptoms. Symptomatology of late onset men was less severe than that of late onset women or that of early onset schizophrenics in general. Familial risk in late onset cases was lower than in early onset cases. The course of late onset cases seemed to be milder. Again, the course in late onset women was worse than that in late onset men.
Late onset schizophrenia essentially seems to be very similar to early onset schizophrenia and apparently belongs to the same group of diseases. However, symptomatology and course are influenced by the higher age of the patients and many age-specific characteristics. The excess of women among late onset schizophrenia as well as their more severe symptomatology and course could be due to the protective effect of estrogens.
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