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However, early neuropathological studies have shown that the incidence of Alzheimer's disease (AD) in schizophrenia patients does not differ from that in controls. These inconsistent results may be attributable to the inclusion of non\u2010AD dementia, but there have been few clinicopathological studies in older patients with schizophrenia based on the current neuropathological classification. This study aimed to investigate the neuropathological basis of incident dementia in older patients with schizophrenia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We systematically examined 32 brains of old patients with schizophrenia using standardized pathological methods. The severity of dementia\u2010related neuropathologies was analyzed using standardized semiquantitative assessments. After excluding patients who fulfilled the neuropathological criteria, clinicopathological variables were compared between patients with and without incident dementia to identify potential differences.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Seven patients fulfilled the pathological criteria for AD (<jats:italic>n<\/jats:italic>\u2009=\u20093), argyrophilic grain disease (AGD) (<jats:italic>n<\/jats:italic>\u2009=\u20092), dementia with Lewy bodies (<jats:italic>n<\/jats:italic>\u2009=\u20091), and AGD\/progressive supranuclear palsy (<jats:italic>n<\/jats:italic>\u2009=\u20091). Among 25 patients for whom a neuropathological diagnosis was not obtained, 10 had dementia, but the clinicopathological findings did not differ from the remaining 15 patients without dementia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Two types of older schizophrenia patient present dementia: patients with co\u2010existing neurodegenerative disease and patients who do not meet pathological criteria based on the current classification. To understand the neurobiological aspects of incident dementia in older patients with schizophrenia, further clinicopathological studies are needed that do not simply analyze incident dementia as a comorbidity of conventional dementia\u2010related neuropathologies.<\/jats:p><\/jats:sec>","DOI":"10.1111\/pcn.13597","type":"journal-article","created":{"date-parts":[[2023,9,14]],"date-time":"2023-09-14T17:12:46Z","timestamp":1694711566000},"page":"29-40","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Neuropathological substrate of incident dementia in older patients with schizophrenia: A clinicopathological study"],"prefix":"10.1111","volume":"78","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8700-8106","authenticated-orcid":false,"given":"Shusei","family":"Arafuka","sequence":"first","affiliation":[{"name":"Department of Psychiatry Nagoya University Graduate School of Medicine  Nagoya 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