Aging in Schizophrenia: Clinical, Biological, and Psychosocial Perspectives

Abstract

Background/Objectives: Schizophrenia is a chronic psychiatric disorder traditionally associated with early adulthood; however, an increasing number of individuals are now reaching older age, highlighting the need to better understand the aging process in this population. Emerging evidence suggests that schizophrenia may be associated with accelerated aging, characterized by an earlier onset of age-related conditions and increased vulnerability to physical and cognitive decline. Methods: We provide an integrative overview of aging in schizophrenia, focusing on biological mechanisms, clinical manifestations, and psychosocial dimensions. Results: Key biological processes, including oxidative stress, mitochondrial dysfunction, chronic immune activation, and dysregulation of stress-response systems, are discussed as potential contributors to accelerated aging. Clinically, older individuals with schizophrenia present a high burden of cardiometabolic comorbidities, persistent cognitive impairment, and increased functional dependency, often compounded by the complexity of pharmacological management in this age group. In addition, psychosocial factors such as social isolation, stigma, and caregiver burden play a critical role in shaping health outcomes and quality of life. Conclusions: Despite growing recognition of these challenges, aging in schizophrenia remains an underexplored area, with significant gaps in longitudinal research and limited focus on older populations. A comprehensive approach that integrates biological, clinical, and psychosocial perspectives is essential to better characterize aging trajectories and to inform more effective and person-centered care strategies in this vulnerable population.