Dementia And Schizophrenia: Similarities And Differences

On the surface, dementia and schizophrenia may seem similar. They can both affect people’s behavior, thoughts, and emotions, often in similar ways. However, dementia usually develops much later in life, and its causes and treatments tend to differ from those of schizophrenia. Still, both individuals living with schizophrenia and those who have dementia may benefit from working with a licensed therapist to develop healthy coping skills and work through challenging thoughts and emotions.

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Understanding dementia, cognitive effects, and Alzheimer’s disease

Let’s start by looking at dementia, which often (though not always) occurs in older adults. Dementia is not an illness itself. Rather, dementia can be seen as a term describing several conditions that can affect people’s cognitive function, such as the following:

• Alzheimer’s disease: Alzheimer’s is a type of dementia that usually becomes more common with age. This disease is thought to be caused by the buildup of certain proteins in the brain. 
• Frontotemporal dementia: This rare form of dementia often affects people under the age of 60. Like Alzheimer’s, frontotemporal dementia can be caused by abnormal protein buildup in the brain. 
• Vascular dementia: This is a type of dementia typically caused by issues with blood flow to the brain, such as blood clots or blood vessel damage. 
• Mixed dementia: This is a term for dementia with more than one cause. For example, a person might have Alzheimer’s disease and vascular dementia at the same time. 

Dementia symptoms often start gradually and can vary depending on the type. Some common examples include those listed below:

• Struggling to talk, read, write, or remember information
• Getting lost in familiar places
• Becoming easily confused
• Hallucinating (seeing, hearing, or feeling things that aren’t there)
• Having delusions (false beliefs that can’t be changed)
• Experiencing paranoia (intense suspicion of others)
• Behaving impulsively
• Losing interest in daily activities

Some of these symptoms, like minor forgetfulness, can be natural as people get older. However, dementia is not usually considered a typical part of aging. 

While there may not be a single cause, scientists have identified several risk factors that may make a person more likely to develop dementia. These may include the following:

• Hearing loss
• Smoking
• High blood pressure
• Depression
• Obesity
• Drinking too much alcohol
• Not getting enough exercise

Other factors that may raise the risk of a dementia diagnosis include having a family history of dementia and having a history of brain injuries. Some studies have also found a possible link between depression and developing dementia. 

Many people live well into old age without ever developing dementia. However, those who do may experience various challenges as a result. Some people with dementia may need daily assistance, a responsibility that often falls to their friends and family members. That said, various treatments are available that may slow the progression of dementia and improve the quality of life.

An overview of schizophrenia

Now that we’ve reviewed dementia, let’s take a look at schizophrenia: a severe mental illness that can change the ways people think and act. Schizophrenia is primarily known for causing psychosis, a state in which a person loses track of what’s real and what’s not. This can have significant effects on their work, relationships, and daily lives. 

Schizophrenia symptoms are usually broken into two categories: positive and negative. Positive symptoms of schizophrenia, sometimes referred to as psychotic symptoms, may include those below:

• Hallucinations
• Delusions
• Disorganized thinking (thoughts that jump around or don’t follow logic)
• Disorganized speech (mixing up words, going off on tangents, or talking in ways others can’t understand)

On the other hand, negative symptoms may include the following:

• A lack of emotional expression, such as failing to use facial expressions or hand gestures
• Low motivation to do tasks
• A loss of interest in interacting with other people
• A lack of ability to feel pleasure

Cognitive symptoms can be seen as a third type of schizophrenia symptom. These are symptoms that can reduce the following abilities:

• Thinking abstractly
• Remembering information
• Paying attention
• Solving problems
• Making plans

Schizophrenia used to be divided into different subtypes based on which symptoms a person experienced. This is no longer the case. In the latest version of the Diagnostic and Statistical Manual of Mental Disorders, the DSM-5, schizophrenia is listed as a “spectrum disorder.” This generally means that its symptoms and effects can look different for different people, but they all fall under the schizophrenia umbrella. 

The exact causes of schizophrenia aren’t yet fully understood, although genetics are likely to play a role. Other risk factors that have been identified may include those listed below:

• Having a low birth weight
• Living in an urban environment
• Complications during birth
• Being born in the winter
• Using cannabis, especially at a young age

Considered chronic, schizophrenia tends to require lifelong support, and those with schizophrenia may be at a higher risk of mental illnesses like depression and anxiety. However, with the right treatment, such as medication, many people with schizophrenia can manage their symptoms. Some may even experience a full recovery. 

Dementia and schizophrenia: Areas of overlap, differences, and potential links

Schizophrenia and dementia may have several similarities, especially in regard to their symptoms. As we’ve seen, both chronic schizophrenia patients and dementia patients may have symptoms like:

• Cognitive impairment
• Changes in thoughts and speech
• Delusions
• Hallucinations
• Paranoia
• A loss of interest in activities

However, there can also be many differences between these two conditions, such as their age of onset. In general, dementia tends to start in older age, usually around age 65 or later. On the other hand, schizophrenia tends to start during young adulthood, often between ages 18 and 30. 

Late- and very late-onset schizophrenia are possible, but they tend to be rare. Scientists have proposed that schizophrenia-like symptoms emerging after age 60 are more likely to be caused by something other than schizophrenia.

Another key difference may be the medications used to treat the two disorders. Schizophrenia is usually treated with antipsychotic medications. These normally work by changing the balance of chemicals in the brain to reduce psychotic symptoms. In contrast, medications for dementia usually target different brain chemicals to improve people’s mental function. Some also work by reducing the buildup of harmful proteins in the brain. Please note that you should always consult your doctor before starting, stopping, or changing the way you take any form of medication.

Finally, dementia tends to be more common than schizophrenia. According to the World Health Organization, schizophrenia affects around 24 million people worldwide. On the other hand, dementia is estimated to affect more than 55 million people.

On the other hand, dementia is estimated to affect more than 55 million people. 

Schizophrenia and dementia: The two conditions could be connected

Although schizophrenia and dementia are two different conditions, research has found a possible connection between them. In a 2018 review, researchers analyzed data from over 200,000 dementia cases to look for a link to schizophrenia. They found that people with schizophrenia were usually at a significantly higher risk of dementia than those without it. 

In a separate study from 2018, researchers looked at data from over 30,000 patients, some with schizophrenia. They found that those with schizophrenia were nearly twice as likely to develop dementia as those without it. However, they also found that the risk was usually lower in people with schizophrenia who were taking antipsychotic medication. 

Getting help for your symptoms

Living with dementia or schizophrenia can be challenging. However, it may be possible to have a better quality of life with both conditions. That often starts with seeking treatment. If you haven’t already, you may want to talk to your doctor about ways to manage your symptoms. They may recommend medications or lifestyle changes to support your well-being. 

Your doctor may also recommend starting therapy for ongoing support. A therapist may be able to help you improve your thought patterns and find healthy ways to cope with your symptoms. Therapy may also be useful for addressing other mental health concerns you might be experiencing. 

Online therapy for mental health and risk of dementia and schizophrenic symptoms

Both schizophrenia and dementia may affect motivation and the desire to socialize. This may make it harder to leave the house for in-person therapy. Online therapy may help. Platforms like BetterHelp typically enable you to attend therapy from the comfort of your own home. This may be an easier option if you’re living with schizophrenia or dementia. 

Research has shown that online therapy can effectively treat symptoms of depression, which can be common in people with schizophrenia and dementia. In a 2023 study, 108 participants with depression received either internet-based therapy or in-person therapy for 12 weeks. Researchers found that both groups usually saw significant improvements in their symptoms and quality of life.